Predictive model of biliocystic communication in liver hydatid cysts using classification and regression tree analysis

A retrospective study of 672 patients with liver hydatid cyst treated at the surgery department "A" at Ibn Sina University Hospital, Rabat Morocco. Four-teen risk factors for BCC occurrence were entered into CART analysis to build an algorithm that can predict at the best way the occurrence of BCC.Incidence of BCC was 24.5%. Subgroups with high risk were patients with jaundice and thick pericyst risk at 73.2% and patients with thick pericyst, with no jaundice 36.5 years and younger with no past history of LHC risk at 40.5%. Our developed CART model has sensitivity at 39.6%, specificity at 93.3%, positive predictive value at 65.6%, a negative predictive value at 82.6% and accuracy of good classification at 80.1%. Discriminating ability of the model was good 82%.we developed a simple classification tool to identify LHC patients with high risk BCC during a routine clinic visit (only on clinical history and examination followed by an ultrasonography). Predictive factors were based on pericyst aspect, jaundice, age, past history of liver hydatidosis and morphological Gharbi cyst aspect. We think that this classification can be useful with efficacy to direct patients at appropriated medical struct's.Echinococcus granulosus is a tapeworm that resides and grows in the small bowel of dogs and other canines. It produces eggs that pass in the stool. Humans (accidental carrier) become infected through the oral route, either directly from an animal direct contact or by consuming unboiled or unwashed contaminated vegetables. In the duodenum, eggs liberate their larvae which go through the intestinal wall and migrate, via the portal system, to the hepatic gland and other organs [1,2]. Seventy-seven per cent of larvae will grow in the liver and may be able to develop a liver hydatid cyst (LHC) [3]. During cyst progression, biliary ducts pass through pericyst and loose their elasticity. Compression of biliary ducts wall lead to necrosis and fissures [3-6]. The Occurrence of biliocys