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Summary
Biliary enteric fistulas occurred in 0.9% of patients undergoing surgery for nonmalignant biliary tract disease. Definitive treatment involves cholecystectomy and fistula excision, with a 6% operative mortality.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Hepatobiliary Surgery
Background:
- Biliary enteric fistulas are rare complications of biliary tract disease.
- This study reviews a large cohort of patients treated over a significant period.
Purpose of the Study:
- To analyze the incidence, characteristics, and management outcomes of biliary enteric fistulas.
- To evaluate surgical outcomes and recommend optimal treatment strategies.
Main Methods:
- Retrospective review of 105 patients with biliary enteric fistulas treated between 1932 and 1978.
- Analysis of surgical procedures, complications, and mortality rates.
Main Results:
- The incidence of biliary enteric fistulas was 0.9% among 11,808 patients with nonmalignant biliary tract disease.
- Cholecystoduodenal fistulas were most common (77%), followed by cholecystocolic (15%).
- Operative mortality was 6% for definitive procedures and 4.5% for patients with gallstone-induced obstruction.
Conclusions:
- Definitive management should include cholecystectomy, fistula excision, common bile duct exploration, and operative cholangiography.
- Patients presenting with intestinal obstruction require staged surgical intervention.