fistule chistobiliare la 92 (15,5%), fistulele au fost suturate cu omentopexie. La 5 pacienți s-a aplicat intraoperator o microcolecistostomă temporară. La 39 (6,5%) s-au format fistule biliare externe în perioada postoperatorie. La 24 pacienți fistulele s-au închis după tratament medicamentos. La 15 pacienți cu biliragie mai mare de 200 ml s-a efectuat decompresie endoscopică. Rezultate pozitive au fost obținute la 13 pacienți, 2 pacienți au fost reoperați. Nu au fost înregistrate cazuri letale. Concluzii. Afectarea tractului biliar este una dintre cele mai grave complicații ale echinococozei hepatice, înrăutățind rezultatele postoperatorii și obligând la aplicarea unor intervenții endoscopice suplimentare. Implementarea intervențiilor endoscopice decompresive în practica clinică a îmbunătățit semnificativ rezultatele tratamentului chirurgical. Alegerea tehnicii chirurgicale trebuie să se bazeze pe localizarea chisturilor, prezența complicațiilor și starea generală a pacientului

Aim of study. To analyze the efficacy of multicomponent treatment tactics in patients with biliary complications of hepatic echinococcosis. Materials and methods. Treatment outcomes of 592 patients operated on in the clinic over 35 years were analysed. Diagnostic monitoring included: general clinical diagnosis, ultrasonography, CT, MRI in cholangiographic regime, EGD, fistulagram. Results. Mechanical jaundice was detected in 42 (7%) patients at the time of admission, in 35 cases of bile duct compression, patients received intensive preoperative medical treatment, 7 patients with rupture inside the bile ducts underwent emergency endoscopic decompression with removal of cyst fragments and drainage. Echinococectomy was performed 3-5 days later. Out of 392 patients, 92 (15.5%) had chistobiliary fistulae; the fistulae were sutured with omentopexy. In 5 cases a temporary microcholecystostomy was applied intraoperatively. In 39 (6.5%) external biliary fistulas formed postoperatively. In 24 cases the fistulas closed after drug treatment. Endoscopic decompression was performed in 15 cases with bilirubin greater than 200 ml. Positive results were obtained for 13 patients, 2 patients were reoperated. No fatal cases were recorded. Conclusions. Biliary tract damage is one of the most serious complications of hepatic echinococcosis, worsening postoperative outcomes and requiring additional endoscopic interventions. The implementation of endoscopic decompressive procedures in clinical practice has significantly improved surgical treatment outcomes. The choice of surgical technique should be based on the location of the cysts, the presence of complications and the general condition of the patient.