Endoscopic sphincterotomy in the treatment of postoperative biliary fistulas of hepatic hydatid disease

Background: Ten patients with postoperative external biliary fistula treated by endoscopic sphincterotomy are reported. Methods: Nine of these patients were operated for hepatic hydatid disease and one for a liver abscess. Mean daily output of bile through the fistulae which were present for 5–39 days was approximately 500 cc. Results: Treatment was successful in nine patients with closure of the fistulae in 2–15 days (mean, 7 days). No response was obtained in one patient who was reoperated, and an intrahepatic biliary duct was found to be completely eroded by the cyst wall. Conclusions: Endoscopic sphincterotomy should be the first-line treatment for postoperative external biliary fistulae related to hepatic hydatid disease.