Stere Popescu, Tina Popescu, Bogdan Obada, Teodor Ștefan Niţu, Irina Niţu, Maria Sabina Neacşu, Ana Maria Grigorescu, Florin Gabriel Pănculescu, Florin Daniel Enache, Mihai Victor Lupaşcu, Iulian Manac, Daniel Ovidiu Costea
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Pericystic-Digestive Anastomosis for Hepatic Hydatid Cysts: Indications, Outcomes, and a Surgical Decision Algorithm.
Introduction: Pericystic-digestive anastomosis is a rarely used but valuable surgical option in the management of complicated hepatic hydatid cysts. Materials and Methods: This retrospective observational study included 24 patients operated on between 2010 and 2023 in a general surgery center in Romania. We analyzed intraoperative decision-making, type of anastomosis, and postoperative outcomes. Results: Roux-en-Y jejunostomy was performed in 19 patients, and pericystogastrostomy in 5. All patients had intraoperatively confirmed biliary fistulas â?¥5 mm. There were no deaths or reinterventions. Minor complications included transient febrile syndrome (12.5%), delayed bowel transit (8.3%), and one percutaneously drained subhepatic collection (4.1%). Follow-up imaging showed progressive reduction of residual cavities in all cases. Conclusions: When correctly indicated, pericystic-digestive anastomosis provides safe and effective internal drainage for large, centrally located cysts with biliary fistulas and well-organized pericysts. Based on clinical experience and current literature, we propose a practical decision-making algorithm to guide surgical management in complicated hepatic echinococcosis.
期刊介绍:
Chirurgia is a bimonthly journal. In Chirurgia, original papers in the area of general surgery which neither
appeared, nor were sent for publication in other periodicals, can be published. You can send original articles,
new surgical techniques, or comprehensive general reports on surgical topics, clinical case presentations and,
depending on publication space, - reviews of some articles of general interest to surgeons from other publications.
Chirurgia is also a place for sharing information about the activity of various branches of the Romanian Society of
Surgery, information on Congresses and Symposiums organized by the Romanian Society of Surgery and
participation notes in other scientific meetings.
Letters to the editor: Letters commenting on papers published in Chirurgia are welcomed. They should contain
substantive ideas and commentaries supported by appropriate data, and should not exceed 2 pages. Please
submit these letters to the editor through our online system.