Role of ERCP in The Management of Biliary Complications of Hepatic Hydatid Cysts

Author's Information:

M. Tahiri

Department of Hepato-Gastroenterology, Ibn Rochd University Hospital, Casablanca, Morocco

A.L. Cheikh Baye

Department of Hepato-Gastroenterology, Ibn Rochd University Hospital, Casablanca, Morocco 

H.H. Abakar

Department of Hepato-Gastroenterology, Ibn Rochd University Hospital, Casablanca, Morocco 

Z. Boukhal

Department of Hepato-Gastroenterology, Ibn Rochd University Hospital, Casablanca, Morocco

F.Z. El Rhaoussi

Department of Hepato-Gastroenterology, Ibn Rochd University Hospital, Casablanca, Morocco 

F. Haddad

Department of Hepato-Gastroenterology, Ibn Rochd University Hospital, Casablanca, Morocco 

W. Hliwa

Department of Hepato-Gastroenterology, Ibn Rochd University Hospital, Casablanca, Morocco 

A. Bellabah

Department of Hepato-Gastroenterology, Ibn Rochd University Hospital, Casablanca, Morocco 

W. Badre

Department of Hepato-Gastroenterology, Ibn Rochd University Hospital, Casablanca, Morocco

Vol 06 No 03 (2026):Volume 06 Issue 03 March 2026

Page No.: 39-41

Abstract:

Hepatic hydatid cysts, caused by Echinococcus granulosus, frequently complicate via rupture into the biliary tract, presenting a major therapeutic challenge. This retrospective study (2019–2023) evaluated the efficacy of endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy in managing eight patients with cystobiliary fistulization. All patients presented with acute cholangitis and cholestasis. Endoscopic extraction of hydatid material was universally successful, leading to the resolution of jaundice within 5 to 12 days. No post-procedural complications were observed. The study concludes that ERCP is a highly effective, safe, and minimally invasive first-line treatment for biliary complications of hepatic hydatid disease, superior to traditional surgery.

KeyWords:

Hepatic hydatid cyst, ERCP, Endoscopic sphincterotomy, Biliary complications, Cystobiliary fistula, Acute cholangitis.

References:

  1. Organisation mondiale de la Santé – Échinococcose (données épidémiologiques mondiales)
  2. https://www.who.int/news-room/fact-sheets/detail/echinococcosis
  3. Brunetti E, Kern P, Vuitton DA.
  4. Expert consensus for the diagnosis and treatment of cystic echinococcosis.
  5. PubMed : https://pubmed.ncbi.nlm.nih.gov/18335809/
  6. Atli M, Kama NA, Yuksek YN, et al.
  7. Intrabiliary rupture of a hepatic hydatid cyst: associated clinical factors and proper management.
  8. PubMed : https://pubmed.ncbi.nlm.nih.gov/16442947/
  9. Dolay K, Akbulut S, Ersan Y, et al.
  10. Endoscopic sphincterotomy in the management of postoperative biliary fistulas after hydatid liver surgery.
  11. PubMed : https://pubmed.ncbi.nlm.nih.gov/14528213/
  12. Akcan A, Akyildiz H, Artis T, et al.
  13. Perforation of hydatid cysts of the liver into the biliary tract.
  14. PubMed : https://pubmed.ncbi.nlm.nih.gov/17036483/
  15. Lewall DB.
  16. Hydatid disease: biology, pathology, imaging and classification.
  17. PubMed : https://pubmed.ncbi.nlm.nih.gov/3512410/
  18. Dziri C, Haouet K, Fingerhut A.
  19. Treatment of hydatid cyst of the liver: where is the evidence?
  20. PubMed : https://pubmed.ncbi.nlm.nih.gov/16311838/
  21. Tasev V, Dimitrov R, Draganov K.
  22. Endoscopic management of biliary complications of hepatic hydatid disease.
  23. PubMed : https://pubmed.ncbi.nlm.nih.gov/22725113/
  24. Manouras A, Genetzakis M, Antonakis PT, et al.
  25. Endoscopic treatment of intrabiliary rupture of hydatid cyst of the liver.
  26. PubMed : https://pubmed.ncbi.nlm.nih.gov/26345677/
  27. Revue générale – complications biliaires du kyste hydatique (PMC)
  28. https://pmc.ncbi.nlm.nih.gov/articles/PMC9338722/