Fistula formation in hepatic cystic echinococcosis: clinical impact, predictors, and outcomes from a 27-year cohort
Transactions of The Royal Society of Tropical Medicine and Hygiene·
- DOI
- 10.1093/trstmh/trag098
- PMID
- —
- PMCID
- —
- OpenAlex
- —
- Study type
- Cohort study
- Publisher
- Oxford University Press (OUP)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The abstract presents fistula formation as a marker of greater disease complexity in hepatic cystic echinococcosis and identifies features associated with its occurrence. It describes possible relevance to monitoring and intervention in endemic settings, but this single-centre retrospective study does not establish population-level effects or surveillance trends.
Structured evidence summary
Research question
The study examined which clinical characteristics were associated with fistula formation in hepatic cystic echinococcosis and whether fistulization was associated with patient outcomes.
Study design
This was a retrospective observational cohort study of patients with cystic echinococcosis managed at a tertiary referral centre from 1998 to 2025. Patients with hepatic involvement were compared according to whether fistula formation was present.
Population and setting
The cohort included 539 patients with hepatic cystic echinococcosis treated at a tertiary referral centre. Fistula formation occurred in 87 patients; most were cystobiliary fistulas, with additional transdiaphragmatic fistulas reported.
Main findings
Fistula formation was reported in 16.1% of patients and was associated with younger age, more frequent symptoms, and more complications. Active cyst stages, cyst diameter greater than 7 cm, and eosinophilia were independently associated with fistula formation. The abstract reports no significant differences in recurrence, mortality, or hospital-stay length between patients with and without fistulas.
Public-health relevance
The abstract presents fistula formation as a marker of greater disease complexity in hepatic cystic echinococcosis and identifies features associated with its occurrence. It describes possible relevance to monitoring and intervention in endemic settings, but this single-centre retrospective study does not establish population-level effects or surveillance trends.
Important limitations
The retrospective design and tertiary-referral setting may limit comparability with other clinical settings and do not establish causal relationships. This summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation of methods, adjustment procedures, and outcome assessment.
GIDS interpretation
The supplied metadata classifies the article under echinococcosis and treatment, supporting discoverability in those evidence contexts. It provides no country linkage or surveillance dataset, so the article should be treated as single-study clinical evidence rather than confirmation of a live surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 5 auditable classifier relationships to diseases, places, topics, and study design.