SURGICAL TREATMENT OF COMPLICATED DUCTUS CHOLEDOCHUS HYDATIDOSIS DURING THE COVID-19 PANDEMIC: EFFECTIVENESS AND LIMITATIONS OF RADIOLOGICAL SERVICES AND SURGERY IN EXTRAORDINARY CONDITIONS

Krstina S Doklestić; Dragan Vasin; Dušan Micić; Nikola Grubor; Vladimir Resanovic; Ivana Lešević; Ognjen Duka; Vinka Bajić; Goran Vuković; Ksenija MIjović; Aleksandar Pavlović; Jelena Mitrović; Zlatibor Lončar

doi:10.5937/sanamed0-52725

Krstina S Doklestić 1. University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 2. University Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia
Dragan Vasin 1. University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 2. University Clinical Center of Serbia, Center for radiology and MRI, Belgrade, Serbia
Dušan Micić 1.University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 2. University Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia
Nikola Grubor 1. University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 2. University Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia
Vladimir Resanovic 1. University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 2. University Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia
Ivana Lešević University Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia
Ognjen Duka University Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia
Vinka Bajić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Goran Vuković 1. University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 2. University Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia
Ksenija MIjović University Clinical Center of Serbia, Center for radiology and MRI, Belgrade, Serbia
Aleksandar Pavlović University Clinical Center of Serbia, Center for radiology and MRI, Belgrade, Serbia
Jelena Mitrović University Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia
Zlatibor Lončar 1. University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 2.University Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia

DOI: https://doi.org/10.5937/sanamed0-52725

Keywords: Choledocho-Hydatididosis (CH), Complicate Hydatid cysts (CHC), Intraoperative ultrasound, Hydatid disease (HD), Liver surgery

Abstract

Introduction: While uncomplicated echinococcal cysts can grow in the liver for years without symptoms, complicated hydatid cysts (CHC) present distinct clinical characteristics that necessitate urgent treatment.

Case Report: We present a case of acute biliary obstruction, cholangitis, and sepsis due to massive choledocho-hydatididosis in an 84-year-old COVID-positive patient during the COVID-19 pandemic. Imaging revealed a multicystic lesion in liver segments V and VIII that compressed surrounding liver tissue, leading to intrahepatic duct dilation. A daughter cyst in the ductus choledochus was confirmed during surgery. An attempt at endoscopic retrograde cholangiopancreatography (ERCP) was unsuccessful. We performed an open pericystectomy with total cystectomy and choledochotomy, carefully evacuating all hydatid cysts. The postoperative course was uneventful, and the patient was discharged without surgical complications.

Conclusion: Complicated hydatid cysts (CHC) leading to acute biliary obstruction require prompt diagnosis and indicate the need for rapid evacuation of the cyst and correction of complications.

Author Biography

Krstina S Doklestić, 1. University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 2. University Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia

Specijalista opšte hirurgije, Klinički Asistent na Katedri za hirurgiju sa anesteziologijom, Medicinskog fakulteta Univerziteta u Beogradu

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