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Papers by Haldun Gundogdu

Ulusal Cerrahi Dergisi, 2007

Komplikasyonsuz majör cerrahi işlemlerden sonra hastanın hastanede kalış süresini belirleyen fakt... more Komplikasyonsuz majör cerrahi işlemlerden sonra hastanın hastanede kalış süresini belirleyen faktörler parenteral analjezik ve sıvı ihtiyacı ile mobilizasyondaki kısıtlamalardır. Yakın geçmişte alınan bazı sonuçlara göre hastanın normal fonksiyonlarına dönüş ve hastanede kalış süresi kısaldıkça komplikasyon oranı da azalmaktadır (1-3). Hastanede kalış süresinin azaltılması hastanın normal vücut fonksiyonlarına daha çabuk dönmesi ile söz konusu olabileceğine göre, cerrahi nedeniyle gelişecek fonksiyon kaybını minimuma indirmek temel amaç olarak belirmektedir. İlk bakışta kolay gibi görünse de bunun sağlanabilmesi için multimodal bir yaklaşıma ve gelenekselleşmiş birtakım uygulamalarda cesur ve kanıta dayalı değişimlere ihtiyaç duyulmaktadır.

The Turkish Journal of Gastroenterology the Official Journal of Turkish Society of Gastroenterology, 2009

Turkiye Klinikleri Journal of Medical Sciences, 1992

... Cerrahide Total Parenteral Nutrisyon Dr.Haldun GÜNDOĞDU * , Doç.Dr.Ali GÖREN ** , Dr.Zeynep G... more ... Cerrahide Total Parenteral Nutrisyon Dr.Haldun GÜNDOĞDU * , Doç.Dr.Ali GÖREN ** , Dr.Zeynep GÖNÜL *** , Dr.Mustafa Ş. ONARAN * * Türkiye Yüksek İhtisas Hastanesi Gastroenterolojik Cerrahi Bölümü ** Türkiye Yüksek ...

Clinical Nutrition, 2015

Malnutrition represents a serious health care threat, as it increases morbidity, mortality and he... more Malnutrition represents a serious health care threat, as it increases morbidity, mortality and health care cost. The effective screening and treatment with enteral (EN) or parenteral (PN) nutrition are the key elements of the policy called Optimal Nutrition Care for All (ONCA). The study tried to analyze the impact of the state's economy on the implementation of EN and PN to define its role in ONCA. an international survey in twenty two European countries was performed between January and December 2014. An electronic questionnaire was distributed to 22 representatives of clinical nutrition (PEN) societies. The questionnaire comprised questions regarding country economy, reimbursement, education and the use EN and PN. Return rate was 90.1% (n = 20). EN and PN were used in all countries surveyed (100%), but to different extent. The country's income significantly influenced the reimbursement for EN and PN (p < 0.05). It was also associated with the overall use of tube feeding and PN (p = 0.05), but not with the use of oral nutritional supplements (p = 0.165). The use of both, EN and PN at hospitals was not depended on the economy (p > 0.05). Education was actively carried out in all countries, however the teaching at the pre-graduate level was the least widespread, and also correlated with the country income (p = 0.042). Results indicated that economic situation influences all aspects of ONCA, including education and treatment. The reimbursement for EN and PN seemed to be the key factor of effective campaign against malnutrition.

Indian Journal of Surgery, 2014

Journal of Laparoendoscopic & Advanced Surgical Techniques, 1998

Although extensive research has been carried out on the respiratory and renal effects of intra-ab... more Although extensive research has been carried out on the respiratory and renal effects of intra-abdominal pressure increase, there is limited research with regard to its effects on bacterial translocation. The objective of this study was to discuss whether the high intra-abdominal pressure due to carbon dioxide (CO2) insufflation during laparoscopy leads to bacterial translocation. Eighteen male dogs, 7 of which constituted the control group, were used in the study. Two study groups, in which the intra-abdominal pressure was raised to 15 mm Hg and kept at that level for 30 and 120 minutes, respectively, were set. Blood gases and blood pressure values were observed throughout the experiments. Samples of peritoneal smear, portal vein blood, mesenteric lymph node, liver, spleen, and cecum were examined to detect bacterial translocation. Histopathological examinations of all samples were also carried out. No translocation was detected in the samples of peritoneal smear, portal blood, mesenteric lymph node, liver, or spleen, but in the samples of cecum, bacterial colonization for the second group (p<0.05) and for the third group (p<0.05) was significantly higher compared with the control group. There was a considerable difference between the second and third groups (p<0.05). The changes in the mesenteric lymph nodes were interpreted to be a result of bacterial drainage. Histopathological examination disclosed active changes in the mesenteric lymph nodes in all groups, but there was considerable sinus histiocytosis only in the third group. We conclude that the intraabdominal pressure of 15 mm Hg created by carbon dioxide insufflation does not lead to bacterial translocation but causes intraluminal bacterial colonization in the cecum after 30 minutes and after 2 hours.

Clinical Nutrition, 2009

Background & aims: We conducted a multicentre study to assess nutritional risk at hospital admiss... more Background & aims: We conducted a multicentre study to assess nutritional risk at hospital admission, hospital-associated iatrogenic malnutrition and the status of nutritional support in Turkish hospitals.

Journal of Gastroenterology and Hepatology Research, Jul 21, 2014

Turkish Journal of Surgery, 2015

It has been proven that malnutrition increases postoperative morbidity and mortality, and it may ... more It has been proven that malnutrition increases postoperative morbidity and mortality, and it may also negatively affect wound healing in the gastrointestinal tract. In the literature, there is only one study evaluating the effects of preoperative nutritional support on colonic anastomotic healing under malnourished conditions. In order to improve the data on this topic, an experimental study was planned to evaluate the effects of preoperative nutritional support on colonic anastomotic healing in malnourished rats. The study included 18 male Wistar albino rats divided into 3 groups. The control (C) group was fed ad libitum for 21 days. The malnutrition (M) group and preoperative nutrition (P) group were given 50% of the daily food consumed by the rats in Group C for 21 days to induce malnutrition. At the end of 21 days, Group P was fed ad libitum for 7 days (preoperative nutritional support). Colonic transection and end-to-end anastomosis was performed at 21 days in Group C and Group M and at 28 days in Group P. The rats were sacrificed at postoperative 4 days, anastomotic bursting pressure was measured, and samples were taken to analyze tissue hydroxyproline levels. Anastomotic bursting pressure was significantly higher in Group C than in Group M and Group P (p<0.05), and it was significantly higher in Group P than in Group M (p<0.05). Tissue hydroxyproline levels in Group P were found to be significantly higher than those in Group M and Group C (p<0.05). One week of preoperative nutritional support increases collagen synthesis in the colon and positively affects anastomotic healing under malnourished conditions.

World journal of emergency surgery : WJES, 2006

The role of free oxygen radicals in inflammatory conditions is well known. Free radicals cause li... more The role of free oxygen radicals in inflammatory conditions is well known. Free radicals cause lipid peroxidation of cellular membranes resulting in cell death. The purpose of this study was to investigate the levels of total anti-oxidant status (TAS), as a marker of anti-oxidant defense system and malondialdehyde (MDA), as a marker of oxidative stress, in the plasma of patients with acute appendicitis. Fifty-one adult patients with a median age of 31 years who underwent operations with a preoperative diagnosis of acute appendicitis were included in this prospective study. Blood samples for C-reactive protein (CRP), MDA and TAS were collected preoperatively. Groups were compared by using the Mann-Whitney U test. There were 27 patients with acute phlagmenous appendicitis and 19 patients with advanced appendicitis (10 gangrenous and 9 perforated appendicitis), while 5 negative explorations were documented. No significant differences in WBC counts and MDA levels between groups were enc...

Indian Journal of Surgery, 2013

The aim of the present prospective randomized controlled trial is to compare the effectiveness of... more The aim of the present prospective randomized controlled trial is to compare the effectiveness of intravenous and oral antibiotic prophylaxis for cost and surgical site infection in elective laparoscopic cholecystectomy. Three hundred twenty patients were split into two groups as to include 160 patients in each, and they were evaluated in a prospective and randomized fashion. While one group was subjected to 1 g cefazolin via intravenous route during anesthesia induction, other group received 1 g cephalexin monohydrate via oral route 1 h prior to the operation. Demographic findings and operation results of the patients were compared by analyses. Our 320 patients (278 females and 42 males) received elective cholecystectomy and were followed up for a period of 6-26 months. Each group had 160 patients. Both groups were similar with regard to demographic characteristics and inclusion criteria. Among all, only five (1.5 %) cases demonstrated postoperative surgical site infection. Surgical site infection at postoperative period was determined in three (1.8 %) cases of intravenous prophylaxis group and two (1.2 %) cases of oral prophylaxis group. There was no statistically significant difference between the groups in terms of surgical site infection. Oral antibiotic prophylaxis can be used in elective laparoscopic cholecystectomy prophylaxis due to its cost-effective, reliable nature, and low surgical site infection rate.

Turkish Journal of Surgery, 2012

International Surgery, 2014

Transplantation Proceedings, 2003

Long-term parenteral nutrition (PN) and intestinal transplantation (IT) are life-saving therapies... more Long-term parenteral nutrition (PN) and intestinal transplantation (IT) are life-saving therapies for patients with short bowel syndrome (SBS). However, indications and timing of these therapies are controversial. In this study we aimed to evaluate the indications for IT. Forty-two patients, each with Ͻ100 cm of small bowel, were divided into three groups according to the length of remnant: group I patients (n ϭ 18): colon plus 50 to 100 cm of small bowel (SB); group II patients (n ϭ 14): colon plus Ͻ50 cm of SB; and group III patients (n ϭ 10): Ͻ50 cm of SB without colon. One-year mortality rates for groups I, II, and III were 50%, 72%, and 100%, respectively. All group I survivors developed intestinal adaptation, returning to regular oral feedings at 1 year. Interestingly, three of four surviving patients in group II developed adaptation and were fed an oral short bowel diet (SBD) at 1 year. None of the group III patients survived Ͼ1 year, dying due to multiorgan failure in the early postoperative period or from sepsis within 1 year. We conclude that patients with a very short bowel are candidates for IT when stable. If the colon is intact, however, regardless of small bowel remnant length, the patient should be given a chance to develop intestinal adaptation before making the decision for permanent PN or IT.

Journal of Surgical Research, 2008

Purpose. The aim of the present study was to evaluate the efficacy of an absorbable polylactic ac... more Purpose. The aim of the present study was to evaluate the efficacy of an absorbable polylactic acid film barrier in preventing postoperative intra-abdominal adhesions, inflammation, and fibrosis in an animal model.

Journal of Surgical Research, 2005

A total of 46 adult male Wistar mice weighing between 25 to 35 g were included in the study. The ... more A total of 46 adult male Wistar mice weighing between 25 to 35 g were included in the study. The animals were fed with standard diet and water ad libitum during the experiment. All animals were housed separately and kept under standard conditions of room temperature at 22 to 24°C and within a 12-h light/12-h dark cycle.

Journal of Gastrointestinal Surgery, 2009

Purpose The aim of this study was to evaluate the efficacy of two absorbable film barriers, polyl... more Purpose The aim of this study was to evaluate the efficacy of two absorbable film barriers, polylactic acid and sodium hyaluronate-carboxymethyl cellulose, in preventing postoperative intra-abdominal adhesions, inflammation, and fibrosis in an animal model. Methods Forty Wistar albino rats were grouped as polylactic acid, sodium hyaluronate-carboxymethyl cellulose, and control. All rats underwent laparotomy with subsequent cecal wall abrasion and abdominal wall injury. The two treatment groups received polylactic acid or sodium hyaluronate-carboxymethyl cellulose film barriers, while control group received nothing. On postoperative day 21, three observers graded the intra-abdominal adhesions and resected specimens. Fibrosis, inflammation, and adhesions were graded using quantitative scoring systems.

Gazi Medical Journal, 2012

Digestive Surgery, 2001

Background: Intrabiliary rupture is one of the most serious complications of liver hydatid cysts ... more Background: Intrabiliary rupture is one of the most serious complications of liver hydatid cysts (LHC). The kind of surgery for these patients is still controversial. T-tube drainage and choledochoduodenostomy (CD) are used by most of the surgeons. But there is no comparative study in the literature. Methods: Eighty patients with symptomatic intrabiliary rupture were treated between 1980 and 1995. All patients had jaundice. In addition to treatment of the cyst cavity, T-tube drainage of the common bile duct (CBD) was performed in 53 patients, 25 patients underwent a CD for biliary drainage and two patients were treated by a T-tube placed in the CBD without treating the cyst. The T-tube drainage and CD groups were compared in regard to morbidity, mortality, duration of the operation, rate of relaparatomy and duration of postoperative hospital stay. Results: The morbidity rate was 40% (10/25) after CD and 18.1% (10/55) after Ttube drainage. Relaparatomy was necessary in 8% (2/25) and 1.8% (1/55) of patients treated with CD and T-tube drainage, respectively. T-tube drainage was performed much more rapidly than CD (p ! 0.05). The length of hospital stay for both groups was the same. One patient who was treated with CD died postoperatively. Conclusion: Our results suggest that T-tube drainage is superior to CD for intrabiliary rupture of LHC in most cases.

Ulusal Cerrahi Dergisi, 2007

Komplikasyonsuz majör cerrahi işlemlerden sonra hastanın hastanede kalış süresini belirleyen fakt... more Komplikasyonsuz majör cerrahi işlemlerden sonra hastanın hastanede kalış süresini belirleyen faktörler parenteral analjezik ve sıvı ihtiyacı ile mobilizasyondaki kısıtlamalardır. Yakın geçmişte alınan bazı sonuçlara göre hastanın normal fonksiyonlarına dönüş ve hastanede kalış süresi kısaldıkça komplikasyon oranı da azalmaktadır (1-3). Hastanede kalış süresinin azaltılması hastanın normal vücut fonksiyonlarına daha çabuk dönmesi ile söz konusu olabileceğine göre, cerrahi nedeniyle gelişecek fonksiyon kaybını minimuma indirmek temel amaç olarak belirmektedir. İlk bakışta kolay gibi görünse de bunun sağlanabilmesi için multimodal bir yaklaşıma ve gelenekselleşmiş birtakım uygulamalarda cesur ve kanıta dayalı değişimlere ihtiyaç duyulmaktadır.

The Turkish Journal of Gastroenterology the Official Journal of Turkish Society of Gastroenterology, 2009

Turkiye Klinikleri Journal of Medical Sciences, 1992

... Cerrahide Total Parenteral Nutrisyon Dr.Haldun GÜNDOĞDU * , Doç.Dr.Ali GÖREN ** , Dr.Zeynep G... more ... Cerrahide Total Parenteral Nutrisyon Dr.Haldun GÜNDOĞDU * , Doç.Dr.Ali GÖREN ** , Dr.Zeynep GÖNÜL *** , Dr.Mustafa Ş. ONARAN * * Türkiye Yüksek İhtisas Hastanesi Gastroenterolojik Cerrahi Bölümü ** Türkiye Yüksek ...

Clinical Nutrition, 2015

Malnutrition represents a serious health care threat, as it increases morbidity, mortality and he... more Malnutrition represents a serious health care threat, as it increases morbidity, mortality and health care cost. The effective screening and treatment with enteral (EN) or parenteral (PN) nutrition are the key elements of the policy called Optimal Nutrition Care for All (ONCA). The study tried to analyze the impact of the state's economy on the implementation of EN and PN to define its role in ONCA. an international survey in twenty two European countries was performed between January and December 2014. An electronic questionnaire was distributed to 22 representatives of clinical nutrition (PEN) societies. The questionnaire comprised questions regarding country economy, reimbursement, education and the use EN and PN. Return rate was 90.1% (n = 20). EN and PN were used in all countries surveyed (100%), but to different extent. The country's income significantly influenced the reimbursement for EN and PN (p < 0.05). It was also associated with the overall use of tube feeding and PN (p = 0.05), but not with the use of oral nutritional supplements (p = 0.165). The use of both, EN and PN at hospitals was not depended on the economy (p > 0.05). Education was actively carried out in all countries, however the teaching at the pre-graduate level was the least widespread, and also correlated with the country income (p = 0.042). Results indicated that economic situation influences all aspects of ONCA, including education and treatment. The reimbursement for EN and PN seemed to be the key factor of effective campaign against malnutrition.

Indian Journal of Surgery, 2014

Journal of Laparoendoscopic & Advanced Surgical Techniques, 1998

Although extensive research has been carried out on the respiratory and renal effects of intra-ab... more Although extensive research has been carried out on the respiratory and renal effects of intra-abdominal pressure increase, there is limited research with regard to its effects on bacterial translocation. The objective of this study was to discuss whether the high intra-abdominal pressure due to carbon dioxide (CO2) insufflation during laparoscopy leads to bacterial translocation. Eighteen male dogs, 7 of which constituted the control group, were used in the study. Two study groups, in which the intra-abdominal pressure was raised to 15 mm Hg and kept at that level for 30 and 120 minutes, respectively, were set. Blood gases and blood pressure values were observed throughout the experiments. Samples of peritoneal smear, portal vein blood, mesenteric lymph node, liver, spleen, and cecum were examined to detect bacterial translocation. Histopathological examinations of all samples were also carried out. No translocation was detected in the samples of peritoneal smear, portal blood, mesenteric lymph node, liver, or spleen, but in the samples of cecum, bacterial colonization for the second group (p<0.05) and for the third group (p<0.05) was significantly higher compared with the control group. There was a considerable difference between the second and third groups (p<0.05). The changes in the mesenteric lymph nodes were interpreted to be a result of bacterial drainage. Histopathological examination disclosed active changes in the mesenteric lymph nodes in all groups, but there was considerable sinus histiocytosis only in the third group. We conclude that the intraabdominal pressure of 15 mm Hg created by carbon dioxide insufflation does not lead to bacterial translocation but causes intraluminal bacterial colonization in the cecum after 30 minutes and after 2 hours.

Clinical Nutrition, 2009

Background & aims: We conducted a multicentre study to assess nutritional risk at hospital admiss... more Background & aims: We conducted a multicentre study to assess nutritional risk at hospital admission, hospital-associated iatrogenic malnutrition and the status of nutritional support in Turkish hospitals.

Journal of Gastroenterology and Hepatology Research, Jul 21, 2014

Turkish Journal of Surgery, 2015

It has been proven that malnutrition increases postoperative morbidity and mortality, and it may ... more It has been proven that malnutrition increases postoperative morbidity and mortality, and it may also negatively affect wound healing in the gastrointestinal tract. In the literature, there is only one study evaluating the effects of preoperative nutritional support on colonic anastomotic healing under malnourished conditions. In order to improve the data on this topic, an experimental study was planned to evaluate the effects of preoperative nutritional support on colonic anastomotic healing in malnourished rats. The study included 18 male Wistar albino rats divided into 3 groups. The control (C) group was fed ad libitum for 21 days. The malnutrition (M) group and preoperative nutrition (P) group were given 50% of the daily food consumed by the rats in Group C for 21 days to induce malnutrition. At the end of 21 days, Group P was fed ad libitum for 7 days (preoperative nutritional support). Colonic transection and end-to-end anastomosis was performed at 21 days in Group C and Group M and at 28 days in Group P. The rats were sacrificed at postoperative 4 days, anastomotic bursting pressure was measured, and samples were taken to analyze tissue hydroxyproline levels. Anastomotic bursting pressure was significantly higher in Group C than in Group M and Group P (p<0.05), and it was significantly higher in Group P than in Group M (p<0.05). Tissue hydroxyproline levels in Group P were found to be significantly higher than those in Group M and Group C (p<0.05). One week of preoperative nutritional support increases collagen synthesis in the colon and positively affects anastomotic healing under malnourished conditions.

World journal of emergency surgery : WJES, 2006

The role of free oxygen radicals in inflammatory conditions is well known. Free radicals cause li... more The role of free oxygen radicals in inflammatory conditions is well known. Free radicals cause lipid peroxidation of cellular membranes resulting in cell death. The purpose of this study was to investigate the levels of total anti-oxidant status (TAS), as a marker of anti-oxidant defense system and malondialdehyde (MDA), as a marker of oxidative stress, in the plasma of patients with acute appendicitis. Fifty-one adult patients with a median age of 31 years who underwent operations with a preoperative diagnosis of acute appendicitis were included in this prospective study. Blood samples for C-reactive protein (CRP), MDA and TAS were collected preoperatively. Groups were compared by using the Mann-Whitney U test. There were 27 patients with acute phlagmenous appendicitis and 19 patients with advanced appendicitis (10 gangrenous and 9 perforated appendicitis), while 5 negative explorations were documented. No significant differences in WBC counts and MDA levels between groups were enc...

Indian Journal of Surgery, 2013

The aim of the present prospective randomized controlled trial is to compare the effectiveness of... more The aim of the present prospective randomized controlled trial is to compare the effectiveness of intravenous and oral antibiotic prophylaxis for cost and surgical site infection in elective laparoscopic cholecystectomy. Three hundred twenty patients were split into two groups as to include 160 patients in each, and they were evaluated in a prospective and randomized fashion. While one group was subjected to 1 g cefazolin via intravenous route during anesthesia induction, other group received 1 g cephalexin monohydrate via oral route 1 h prior to the operation. Demographic findings and operation results of the patients were compared by analyses. Our 320 patients (278 females and 42 males) received elective cholecystectomy and were followed up for a period of 6-26 months. Each group had 160 patients. Both groups were similar with regard to demographic characteristics and inclusion criteria. Among all, only five (1.5 %) cases demonstrated postoperative surgical site infection. Surgical site infection at postoperative period was determined in three (1.8 %) cases of intravenous prophylaxis group and two (1.2 %) cases of oral prophylaxis group. There was no statistically significant difference between the groups in terms of surgical site infection. Oral antibiotic prophylaxis can be used in elective laparoscopic cholecystectomy prophylaxis due to its cost-effective, reliable nature, and low surgical site infection rate.

Turkish Journal of Surgery, 2012

International Surgery, 2014

Transplantation Proceedings, 2003

Long-term parenteral nutrition (PN) and intestinal transplantation (IT) are life-saving therapies... more Long-term parenteral nutrition (PN) and intestinal transplantation (IT) are life-saving therapies for patients with short bowel syndrome (SBS). However, indications and timing of these therapies are controversial. In this study we aimed to evaluate the indications for IT. Forty-two patients, each with Ͻ100 cm of small bowel, were divided into three groups according to the length of remnant: group I patients (n ϭ 18): colon plus 50 to 100 cm of small bowel (SB); group II patients (n ϭ 14): colon plus Ͻ50 cm of SB; and group III patients (n ϭ 10): Ͻ50 cm of SB without colon. One-year mortality rates for groups I, II, and III were 50%, 72%, and 100%, respectively. All group I survivors developed intestinal adaptation, returning to regular oral feedings at 1 year. Interestingly, three of four surviving patients in group II developed adaptation and were fed an oral short bowel diet (SBD) at 1 year. None of the group III patients survived Ͼ1 year, dying due to multiorgan failure in the early postoperative period or from sepsis within 1 year. We conclude that patients with a very short bowel are candidates for IT when stable. If the colon is intact, however, regardless of small bowel remnant length, the patient should be given a chance to develop intestinal adaptation before making the decision for permanent PN or IT.

Journal of Surgical Research, 2008

Purpose. The aim of the present study was to evaluate the efficacy of an absorbable polylactic ac... more Purpose. The aim of the present study was to evaluate the efficacy of an absorbable polylactic acid film barrier in preventing postoperative intra-abdominal adhesions, inflammation, and fibrosis in an animal model.

Journal of Surgical Research, 2005

A total of 46 adult male Wistar mice weighing between 25 to 35 g were included in the study. The ... more A total of 46 adult male Wistar mice weighing between 25 to 35 g were included in the study. The animals were fed with standard diet and water ad libitum during the experiment. All animals were housed separately and kept under standard conditions of room temperature at 22 to 24°C and within a 12-h light/12-h dark cycle.

Journal of Gastrointestinal Surgery, 2009

Purpose The aim of this study was to evaluate the efficacy of two absorbable film barriers, polyl... more Purpose The aim of this study was to evaluate the efficacy of two absorbable film barriers, polylactic acid and sodium hyaluronate-carboxymethyl cellulose, in preventing postoperative intra-abdominal adhesions, inflammation, and fibrosis in an animal model. Methods Forty Wistar albino rats were grouped as polylactic acid, sodium hyaluronate-carboxymethyl cellulose, and control. All rats underwent laparotomy with subsequent cecal wall abrasion and abdominal wall injury. The two treatment groups received polylactic acid or sodium hyaluronate-carboxymethyl cellulose film barriers, while control group received nothing. On postoperative day 21, three observers graded the intra-abdominal adhesions and resected specimens. Fibrosis, inflammation, and adhesions were graded using quantitative scoring systems.

Gazi Medical Journal, 2012

Digestive Surgery, 2001

Background: Intrabiliary rupture is one of the most serious complications of liver hydatid cysts ... more Background: Intrabiliary rupture is one of the most serious complications of liver hydatid cysts (LHC). The kind of surgery for these patients is still controversial. T-tube drainage and choledochoduodenostomy (CD) are used by most of the surgeons. But there is no comparative study in the literature. Methods: Eighty patients with symptomatic intrabiliary rupture were treated between 1980 and 1995. All patients had jaundice. In addition to treatment of the cyst cavity, T-tube drainage of the common bile duct (CBD) was performed in 53 patients, 25 patients underwent a CD for biliary drainage and two patients were treated by a T-tube placed in the CBD without treating the cyst. The T-tube drainage and CD groups were compared in regard to morbidity, mortality, duration of the operation, rate of relaparatomy and duration of postoperative hospital stay. Results: The morbidity rate was 40% (10/25) after CD and 18.1% (10/55) after Ttube drainage. Relaparatomy was necessary in 8% (2/25) and 1.8% (1/55) of patients treated with CD and T-tube drainage, respectively. T-tube drainage was performed much more rapidly than CD (p ! 0.05). The length of hospital stay for both groups was the same. One patient who was treated with CD died postoperatively. Conclusion: Our results suggest that T-tube drainage is superior to CD for intrabiliary rupture of LHC in most cases.