[Spontaneous bilio-digestive fistulas. Experience with 27 cases]

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Biliary-digestive fistulae are uncommon complications encountered during bile duct operations.
• These fistulae represent abnormal connections between the biliary tree and the gastrointestinal tract.

Purpose of the Study:

• To present a series of biliary-digestive fistula cases.
• To analyze the etiology, presentation, diagnosis, and treatment outcomes of these fistulae.

Main Methods:

• Retrospective review of 27 cases of biliary-digestive fistulae.
• Analysis of patient demographics, etiology (calculi, ulcer), fistula location, and clinical presentation.
• Evaluation of diagnostic methods, including radiological examinations (pneumoangiocholia, contrast studies).

Main Results:

• 26 cases were calculus-related, 1 due to ulcer and calculi.
• Most common fistula was gallbladder to duodenum (20 cases).
• Pre-operative diagnosis was challenging (44% suspicion), with radiological imaging being essential; pneumoangiocholia was pathognomonic.

Conclusions:

• Biliary-digestive fistulae require surgical intervention for definitive treatment.
• Effective management leads to good outcomes with low mortality (3%).
• Radiological assessment is critical for pre-operative diagnosis.