The efficacy of methylene blue in showing occult cystobiliary communication in hydatic liver disease
Osman Yüksel, Nusret Akyürek, Hasan Bostancı, Tolga Şahin, Cem Azılı, Altan Aydın
Gazi Üniversitesi Tıp Fakültesi, Genel Cerrahi AD, ANKARA
Abstract
Purpose: Occult cystobiliary fistula is frequently encountered in hydatic liver disease that is usually overt in the postoperative period and leads to certain complications. In the present study it is aimed to evaluate the efficacy of methylene blue injection technique in determining the occult cystobiliary communication in the peroperative period.
Materials and Methods: Thirty five patients with the diagnosis of hydatic liver disease in whom conservative surgery has been performed were included in the study. The patients with biliary soiling of the cyst fluid and overt cystobiliary communication have been determined. In the remaining patient regardless of bile stain the common bile duct was isolated and methylene blue injection was performed.
Results: Of the eight patients with bile stain of the cyst fluid, a cystobiliary communication was shown in 5 (63%). In the remaining 3 patients (37%) in whom no communication could be demonstrated, methylene blue injection showed the communication. In the remaining 27 patients with no sign of cystobiliary communication methylene blue injection showed a communication in 6 (22%).
Conclusion: In hydatic liver disease in which conservative surgery has been performed methylene blue injection technique is a safe and effective procedure in the demonstration of occult cystobiliary communication
Keywords: Hydatic liver disease, occult cystobiliary communication, methylene blue