Background and Clinical Significance: Biliary tract injuries are a recognized complication of laparoscopic cholecystectomy. Early diagnosis and prompt management are crucial to minimize complications such as bile leaks, strictures, and fistula formation. This case report highlights the use of a biodegradable biliary stent in managing a complex biliary injury and discusses the impact of delayed diagnosis on treatment outcomes. Case Presentation: We present the case of a 30-year-old male who sustained a Strasberg E2 biliary tract injury during a laparoscopic cholecystectomy. Initially misdiagnosed, the injury was only recognized on the fourth postoperative day. The patient underwent a Roux-en-Y hepaticojejunostomy and subsequently developed a postoperative biliary fistula, which was managed with percutaneous drainage. A biodegradable biliary stent was later placed to address a stricture and minimize the need for future interventions. One year later, the patient presented with symptoms of cholangitis, and radiological findings revealed a narrowing of the biliary lumen. The stricture was resolved and an endoscopic gastrojejunal shunt was placed to prevent further complications. The patient is currently in good condition with no signs of further complications. Conclusions: This case emphasizes the importance of early diagnosis in managing biliary tract injuries and highlights the potential of biodegradable stents to reduce the need for repeat interventions. Despite a delayed diagnosis necessitating complex surgical procedures, the use of a biodegradable stent proved effective in managing postoperative complications. Further studies are needed to evaluate the long-term efficacy of biodegradable stents in similar clinical scenarios.

Key Clinical Message: Concurrent polycystic liver disease and echinococcus infection can hinder diagnosis. Surgery may be needed for accurate diagnosis and treatment. Multidisciplinary collaboration is crucial. Cystic echinococcosis, caused by Echinococcus granulosus eggs, is a parasitic zoonosis that typically affects humans through accidental ingestion. Polycystic liver disease is a condition characterized by the presence of multiple liver cysts and is often associated with polycystic kidney disease. Here, we present a case of a man in his 70s with a pre‐existing diagnosis of polycystic liver disease. Radiological findings of a suspicious cyst in the S4 segment initially lacked serological evidence of echinococcosis; however, intraoperative confirmation revealed the presence of an echinococcal cyst. This article aims to explore both clinical conditions and highlight the therapeutic considerations for their management. Moreover, we discuss the significance of this unique case, emphasizing the possibility of the coexistence of these two pathologies.

Colorectal cancer (CRC) ranks as the third most prevalent cancer globally, with 25% of patients presenting with metastases; of these, 8% have synchronous liver and peritoneal metastases. Although the concurrent presence of liver and peritoneal metastases was previously considered an absolute contraindication, the feasibility of combined surgery is now being re-evaluated. This study assesses 41 patients who underwent liver surgery for CRC metastases at our center between October 2021 and February 2024. Among these patients, 7 underwent concomitant cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) due to the presence of synchronous liver and peritoneal metastases. We employed simple linear regression to identify parameters that influenced the development of postoperative complications, classified by the Clavien-Dindo (CD) system. The statistical analysis showed only the operative time, the CRS+HIPEC procedure and the length of hospital stay as significative variables on CD outcome, while the different types of liver surgery were not significant. This study suggests that combining liver surgery with CRS+HIPEC may be beneficial for selected patients, potentially improving overall survival without a significant increase in postoperative complications. A multidisciplinary approach is essential to achieve a survival advantage without elevating morbidity rates.