Caustic sclerosing cholangitis. A complication of the surgical treatment of hydatid disease of the liver
J. Belghiti, J. P. Benhamou, S. Houry, P. Grenier, M. Huguier and F. Fekete
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.
