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External biliary fistula

J Dadoukis1, J Prousalidis, D Botsios

  • 14th Surgical Clinic, School of Medicine, Aristotelian University of Thessaloniki, Greece.

HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery
|March 27, 1998
PubMed
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This study reviewed 210 external biliary fistula cases treated between 1970-1992. Most cases resulted from cholecystectomy or hydatid disease surgery, with conservative management being the primary approach.

Area of Science:

  • Gastroenterology
  • Hepatobiliary Surgery

Background:

  • External biliary fistula is a significant complication following various surgical and medical procedures.
  • Understanding the etiological factors and treatment outcomes is crucial for improving patient care.

Purpose of the Study:

  • To analyze the causes and management of 210 cases of external biliary fistula.
  • To evaluate the effectiveness of conservative versus surgical interventions.

Main Methods:

  • Retrospective review of 210 patients treated for external biliary fistula from 1970 to 1992.
  • Categorization of fistula causes including iatrogenic injury, post-surgical complications, and trauma.
  • Analysis of treatment strategies, differentiating between conservative and surgical management.

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Main Results:

  • The most common causes were bile leak after cholecystectomy (85 cases) and hydatid disease surgery (103 cases).
  • Other causes included iatrogenic bile duct injury (7 cases), common bile duct exploration (4 cases), biliary-intestinal anastomosis disruption (4 cases), liver trauma (2 cases), and P.T.C. catheter passage (4 cases).
  • 173 cases were managed conservatively, while 37 cases required surgical intervention.

Conclusions:

  • External biliary fistulas are often associated with cholecystectomy and hydatid disease surgery.
  • Conservative management is feasible and effective for a majority of external biliary fistula cases.
  • Surgical intervention is reserved for specific complex or refractory cases.