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A Complication of the Surgical Treatment of Hydatid Disease of the Liver

Jacques Belghiti, MD; Jean-Pierre Benhamou, MD; Sydney Houry, MD; Philippe Grenier, MD; Michel Huguier, MD; François Fékété, MD

Arch Surg. 1986;121(10):1162-1165.

Abstract
• In five patients, sclerosing cholangitis developed after the surgical treatment of hydatid cyst of the liver. The cyst communicated with the biliary tree, and a scolicidal solution (2% formaldehyde in two patients and 20% sodium chloride in three) was injected into the cyst. Cholangiography showed strictures affecting the intrahepatic biliary tree in two and both the intrahepatic and extrahepatic biliary tree in three. Sclerosing cholangitis in these patients was likely to result from the caustic effect of the scolicidal solution having diffused from the cyst into the biliary tree. We propose to designate this entity "caustic sclerosing cholangitis." Because of the risk of this complication, and the unproved efficacy of intracystic injection of a scolicidal solution in preventing the dissemination of the parasite, we recommend that this maneuver be abandoned in the surgical treatment of hydatid disease of the liver.

(Arch Surg 1986;121:1162-1165)

Author Affiliations
From Hôpital Beaujon, Clichy, France (Drs Belghiti, Benhamou, Grenier, and Fékété), and Hôpital Tenon, Paris (Drs Houry and Huguier).

Footnotes
Accepted for publication Jan 23, 1986.

Reprint requests to Service de Chirurgie Digestive, Hôpital Beaujon, 92118 Clichy Cédex, France (Dr Belghiti).

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