Biliary Fistula and Late Recurrence of Liver Hydatid Cyst: Role of Cysto-biliary Communication

Inclusion Criteria: * Stages CE2 * CE3b According to the WHO-IWGE classification * solitary * symptomatic or asymptomatic * superficial cyst * cases not suited for hepatic resection as the cyst wall abutting critical vascular and biliary structures as hepatic resection is harmful or excessive loss of hepatic tissue Exclusion Criteria: * stages CL, CE1, CE3a, CE4, CE5 according to WHO-IWGE classification of the hydatid cyst * preoperative total bilirubin level greater than 2.0 mg/dl and direct bilirubin level greater than 1.5 mg/dl * common bile duct dilatation greater than 10 mm , or CT, or MRI, previous percutaneous treatment * recurrent cases after any type of surgery, cases with associated extrahepatic or extra-abdominal hydatid cyst * cysts affecting an entire lobe or the main pedicles * stages Cysts that are complicated (ruptured or diseased cysts), deep cysts .Patients who refuse intervention, have a surgical contraindication, are pregnant, have hydatid cysts in both lobes of the liver, previous liver surgery, liver abscess, frank CBC, cases lost during follow-up, cases who refused to take albendazole, or cases who developed albendazole-related issues (disturbed liver function).