[Spontaneous bilio-digestive fistula after intraoperative choledochus ligation]

Intraoperative lesions of the extrahepatic bile ducts during cholecystectomy do occur; the incidence is about 0.2 to 0.8%. Lesions of the hepatic duct and the choledochus duct followed by stenosis (usually of the cystic duct confluent) do occur most frequently. Intraoperative ligation of the hepatic duct or the choledochus duct are the most severe sequelae of biliary surgery; the leading symptom is progressive postoperative obstructive jaundice. A bilio-digestive fistula may be formed spontaneously and may masquerade this complication leading to relapsing cholangitis. Pathogenesis, clinical symptoms and therapy of bilio-digestive fistula are discussed, after an own case report is given.