Hepatic hydatid cyst is one of the common public health problems in Maghreb, remains a benign pathology, but its seriousness concerns its complications, which are largely dominated by cystic rupture in the bile ducts.The aim of this study is to highlight the difficulty of surgical treatment of hydatic cyst, localized in central part of liver and ruptured in biliary ducts with the place of endoscopywe report the cases of three patients with central hepatic hydatid cyst opening in biliary ducts which are treated differently by surgery and endoscopy. Results: The surgery with the radical and conservative treatment in compared to endoscopy procedure was technically more difficult and efficient, but at the expense of morbidities and a longer hospitalization period. Conclusion: Cysto-biliary fistula is the most frequent and the most frightening complication of liver hydatid cyst, the surgery is the gold standard treatment with the conservative and radical methods. however, some locations such as central part of liver make surgery very difficult and dangerous which open the topic of the usefulness of the endoscopy in this problem.