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Objective:To study the effects of biliary fistula on life period of Hepatic Cystic Echinococcosis (C.E.), in order to explore the process of growing, getting old and dying of C.E.Methods:In the animal experiment, mice were divided into experimental group and control group. Mice in experimental group and control group were inoculated with protoscoleces, which was soaked in the human bile and in the normal saline for 20 minutes respectively. Three months later, cyst wet weight and cyst pathological changes were assessed. In the clinical case study, retrospective analysis was carried on 509 cysts of 402 cases for typing under B ultrasound, size and postoperative biliary fistula, in order to explore the relationship between cyst type and biliary fistula rate, cyst size.Result:In the animal study, cyst wet weight of experimental group and control group was 11.94±6.56mg, 23.06±3.02mg,respectively, the variability had statistical significance (P<0.01). The pathological changes of two groups had no significant difference (P>0.05). In the clinical case study, biliary fistula rate of type CL, typeⅠ, typeⅡ, typeⅢ, typeⅣand typeⅤwas 0%,5.2%,36.6%,72.0%,87.1%,90.9% respectively. The variability had statistical significance between type I and type II, (P<0.05)The variability had no statistical significance between type CL and typeⅠ, typeⅡand typeⅢ, typeⅣand typeⅤ, (P>0.05). The biliary fistula rate of live cyst, transitional cyst and was 24.4%,72.0% and 88.1%. The variability had statistical significance between live cyst and, (P<0.05).The variability had no statistical significance between transitional cyst and dead cyst, The mean diameter of the cyst with and without fistula was 9.88±4.29cm and 9.25±3.60cm, between which there was no significant difference. The mean diameter of type CL, typeⅠ, typeⅡ, typeⅢ, typeⅣand typeⅤwas 11.20±1.93cm,9.33±3.48 cm,9.85±4.83cm, 9.45±3.91cm,7.53±3.79cm and 5.64±1.91cm respectively. The variability among type CL, typeⅠ,typeⅡ,typeⅢand between typeⅣand typeⅤhad no statistical significance. The size variability of type CL, typeⅠ,typeⅡ,typeⅢand typeⅣ, typeⅤhad statistical significance.Conclusion:In the time of 20 minutes, bile can not inactive the protoscoleces, however, it can resist the growth of the cyst. The clinical study shows no relationship between cyst diameter and biliary fistula rate. As the cyst getting old and dying, the cyst decreased in size and increased in biliary fistula rate. The biliary fistula is one important reason for death of cyst.
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