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Biliary enteric fistulas

A O Atli1, T Coşkun, A Ozenç

  • 1Department of General Surgery, Hacettepe University of Medicine, Ankara, Turkey.

International Surgery
|July 1, 1997
PubMed
Summary

Biliary enteric fistulas, often caused by gallstones, present with severe symptoms and are difficult to diagnose preoperatively. Early gallbladder removal is recommended to prevent these serious complications.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Hepatobiliary Surgery

Background:

  • Biliary enteric fistula is a rare but serious complication of biliary tract disease.
  • Gallstone-induced inflammation and chronic cholecystitis are primary etiologic factors.

Purpose of the Study:

  • To review the etiologic factors, diagnosis, management, and prognosis of biliary enteric fistulas.
  • To identify risk factors and recommend preventative strategies.

Main Methods:

  • Retrospective review of 31 patients operated for biliary enteric fistula between 1976 and 1994.
  • Analysis of patient demographics, clinical presentation, diagnostic methods, surgical management, and outcomes.

Main Results:

  • The incidence was 0.74% of all biliary tract operations.
  • Common symptoms included abdominal pain, nausea, vomiting, and jaundice.
  • Preoperative diagnosis was achieved in only 16% of cases.
  • 81% of fistulas were secondary to chronic calculous biliary tract disease.
  • Operative mortality was 13%, with complications including wound infection and sepsis.

Conclusions:

  • Biliary enteric fistulas are associated with significant morbidity and mortality.
  • Accurate preoperative diagnosis remains challenging.
  • Early elective cholecystectomy is crucial for preventing complications of chronic calculous cholecystitis, including bilioenteric fistulas.

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