[Spontaneous bilio-biliary fistulae. Experience in 18 cases]

Area of Science:

• Gastroenterology
• Surgical Pathology
• Biliary Tract Surgery

Background:

• Spontaneous biliary fistulae are uncommon complications, accounting for 0.9% of bile duct surgeries.
• These fistulae predominantly affect females, with an average age of 52.

Purpose of the Study:

• To analyze the incidence, etiology, and management of spontaneous biliary fistulae.
• To evaluate surgical outcomes and preferred reconstruction methods.

Main Methods:

• Retrospective analysis of spontaneous biliary fistula cases.
• Surgical intervention involving fistula elimination, calculus removal, and bilio-enteric reconstruction.

Main Results:

• Lithiasis (gallstones) is the primary cause, leading to fistula formation through necrosis.
• Clinical diagnosis is challenging; fistulae are typically incidental surgical discoveries.
• Roux-en-Y jejunal diversion demonstrated preferable outcomes compared to duodenostomy or hepaticoduodenostomy.

Conclusions:

• Spontaneous biliary fistulae necessitate surgical correction for optimal patient outcomes.
• Roux-en-Y diversion is a recommended surgical technique for bilio-enteric reconstruction.
• Surgical management yields good results with a low mortality rate of 5-9%.