Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Biliary Fistula”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMedDate not supplied

[Multi-technical management of biliary fistula].

Biliary fistula is an occasional complication of cholecystectomy and are usually associated to retained biliary stones, surgical trauma of the biliary ducts and local infection. They were mainly treated by surgical methods up to the acquisition of the new endoscopic and percutaneous techniques used together with parenteral and enteral nutrition and new antibiotics. A total of seven patients with diagnosis of biliary fistula were seen between 1984 and 1990 at the "Unidad de Gastroenterología y Cirugía Digestiva" of the Clínica Sanatrix en Caracas. Average age was 50 with ranged between 31 and 76, 4 were male and 3 female. The fistulas were in 1 due to necrotizing pancreatitis, in 3 to lost of the ligation of the cystic duct, 2 were due to accidental injury of the common duct and the last case was a partial dehiscence of a choledoco-jejunostomy after the resection of a common duct cyst. Four of the cases were choledoco-cutaneous fistula, one hepatocutaneous, two hepatoduodenal. All the seven patients had subhepatic collections, one had a retroperitoneal collection, two had subdiaphragmatic collections and one had multiple hepatic abscesses. The abdominal collections were treated by percutaneous drainage using mainly the Ring-McLean and Van Sonnenberg tubes. The fistula was occluded with biliary prosthesis in four cases, using either endoscopic, percutaneous or mixed technique to place the stent. Patency of the stents ranged between 2 weeks and 24 months. Control time was from 2 to 40 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Endoscopic management of postoperative biliary fistulas].

Biliary fistulas have been managed by surgical correction with no good results. From 1986 to 1990, endoscopic therapy was attempted in 24 patients with postoperative persistent biliary-cutaneous fistulas. Endoscopic retrograde cholangiography demonstrated residual biliary stones in 19 patients (79%). The mean fistula drainage was 540 ml/day, and in 75% the site of the fistula was near the cistic duct stump. Sphincterotomy with or without biliary stent placement resulted in rapid resolution of the fistula in 23 patients (95.8%). In those patients treated with biliary stents the fistula healed spectacularly in 24-72 hrs.

Adolescent↗
PubMed1994

[Methods of treatment for suppurative biliary fistulas of amebic etiology].

Experience in the treatment of 43 patients with pyobiliary fistulas which formed after abscessotomy in amebic abscess of the liver is generalized. The fistulas occurred after open drainage in 29 patients, spontaneous opening of the abscess on the external surface of the body in 8, and after operation for transdiaphragmatic opening of a hepatic abscess in 6 patients. Two groups of patients were distinguished according to the method of completion of the operation. Among the 24 patients of the first clinical group 9 were subjected to drainage of the residual cavity with excision of the fistula, biliary fistulas opening into the cavity were closed in 5 patients, and routine drainage of the cavity was performed in other 5 patients. In 5 cases the operation was completed by plastics of the residual cavity with a pedicle diaphragmatic flap. In the second clinical group, filling of the cavity with the omentum was carried out in 13 patients and a variant of operation suggested by the author was used in 6 patients. The organism's immune reactivity was found to be reduced in prolonged existence of the fistula. The author recommends immunostimulants to be included in the therapeutic complex.

Adjuvants, Immunologic↗
PubMed1991

Endoscopic treatment of postoperative biliary fistulae.

Postoperative biliary fistulae are difficult to manage, particularly in the face of obstruction or malignancy. We used endoscopic sphincterotomy or endoprosthesis placement to aide fistula closure in 52 patients with postoperative biliary fistulae. Thirty-seven patients with a fistula were treated with endoscopic sphincterotomy alone. Twenty-four of these 37 patients had a history of lithiasis; 21 patients were treated successfully by endoscopic sphincterotomy alone. The fistula closed in 2.4 +/- 1.6 days. Among the other 13 patients without history of stone disease, the fistula closed in seven cases (54%), 8.4 +/- 2 days after endoscopic treatment. Three patients ultimately required surgical intervention. In 15 patients an attempt was made to pass a 10F endoprosthesis above the fistula. Among the eight patients with successful prosthesis insertion, the fistula healed in six patients (75%). In the seven patients in whom a prosthesis could not be passed endoscopically, the percutaneous transhepatic approach was used. Surgical treatment (hepaticojejunal anastomosis) was ultimately required in two of these seven patients. Sphincterotomy alone is the preferred treatment for biliary fistulae-complicating surgery for gallstone disease. Alternatively, when a fistula is large, endoscopic placement of a prosthesis can be proposed as the first treatment. In cases of endoscopic failure, placement of a prosthesis through the percutaneous transhepatic approach is a useful alternative, particularly when the fistula source is located in the intrahepatic biliary tract.

Biliary Fistula↗
PubMed1975

External biliary fistula.

External biliary fistulas, once common, are now rare: before the present report of 4 cases only 27 cases have been reported in the English literature since 1900. Review of the records of four patients with external biliary fistula confirmed its occurrence in patients over 50 years of age and the variable site for operning of the fistulous tract. Cholecystectomy provided successful treatment in three of the four patients but the fourth was too ill to undergo an operation; in general, definitive treatment is cholecystectomy, together with excision of the fistulous tract if this takes a direct path through the abdominal wall from the gallbladder, or curettage if the course is devious.

Aged↗
PubMed1987

Spontaneous closure of an end biliary fistula.

Most biliary cutaneous fistulas are side fistulas that communicate with the main biliary ductal system. As long as distal obstruction is not present, nearly all fistulas will close spontaneously. The present case of an end biliary fistula due to transection of an aberrant bile duct during cholecystectomy and its successful nonoperative management demonstrate that end fistulas can sometimes be managed without operative intervention.

Adult↗
PubMed1989

[Spontaneous external biliary fistula].

Spontaneous biliary cutaneous fistula is a rare complication of inflammatory perforation of the gallbladder. We describe a 70-year-old woman who developed a fistula between the gallbladder and the skin following drainage of an abdominal wall abscess. In such cases primary drainage of the abscess alone is advisable. Only after the active infection has subsided should definitive cholecystectomy and excision of the fistulous tract be carried out.

Abdominal Muscles↗
PubMed1994

[Endoscopic therapy of postoperative biliary fistula].

A postoperative biliary fistula is a rare but severe complication of biliary surgery. Clinical signs, ultrasound and ERC lead to the diagnosis. Within three years, 37 patients with postoperative bile duct fistulas after cholecystectomy underwent endoscopic therapy. In all patients the biliary fistula healed completely within seven days after insertion of a nasobiliary tube. The nasobiliary tube for postoperative biliary fistulas offers regular radiological controls and reduces the necessity of operative reinterventions on the biliary system.

Biliary Fistula↗
PubMed1995

Efficacy of hepatobiliary scintigraphy in demonstrating cholangio-colic fistulae. Is formation of internal biliary fistula related to external leak closure?

The authors present four cases of internal biliary fistulae (IBF) identified on hepatobiliary scintigraphy. All of the cases share common history of external biliary leak closure. Scintigraphy in all four cases showed a similar pattern of direct visualization of transverse colon without any significant small bowel activity. This suggests an increased frequency of IBF formation in cases with external fistulous tract closure. Retrospectively, it appears that spontaneous closure of external leak may be pathological consequence of formation of IBF involving hepatic flexure.

Adult↗
PubMed1992

Closure of a controlled biliary fistula complicating partial cholecystectomy with endoscopic biliary stenting.

An elderly woman presented 2 months after partial cholecystectomy performed for gangrenous cholecystitis with choledocholithiasis and a controlled biliary fistula. Despite ductal clearance of stones via endoscopic retrograde sphincterotomy and stone extraction, bilious drainage via the fistulous tract persisted. Endoscopic insertion of a 10F Amsterdam endoprosthesis resulted in complete closure of the fistula within 6 wk. This case represents the first example of closure of a biliary fistula after partial cholecystectomy.

Aged↗
PubMed1989

[Percutaneous drainage of fistula-associated abscesses and biliary fistulas].

33 abdominal abscesses associated with fistulae in 31 patients were treated by percutaneous drainage. 19 of these patients had had surgery immediately preceding the drainage. In 64% the percutaneous drainage led to a diagnosis of an internal fistula. Additional therapeutic measures, because of the fistula, were necessary in 45% (operation, biliary drainage, repositioning of catheter). The average duration of drainage was 29 days. 77% of those abscesses which could be drained were treated successfully. Mortality in the entire series was 19%.

Abdomen↗
PubMed1987

Hypercholeresis induced by norchenodeoxycholate in biliary fistula rodent.

The biliary recovery and effect on bile flow and biliary bicarbonate secretion of infused norchenodeoxycholate (nor-CDC), the synthetically prepared C23 homologue of chenodeoxycholate (CDC), were defined in the anesthetized biliary fistula hamster, rat, and guinea pig and compared with those of its taurine conjugate as well as those of the natural C24 bile acid, CDC. In the hamster and rat, nor-CDC was recovered slowly in bile in contrast to its taurine conjugate or CDC. Hepatic biotransformation of nor-CDC was complex. Little amidation with glycine or taurine occurred and the compound was recovered in bile in unchanged form, in the form of hydroxylated derivatives as well as glucuronates and sulfates, the proportion varying in the different species. In contrast, CDC was efficiently amidated with glycine or taurine. The taurine conjugate of nor-CDC was secreted largely unchanged. Nor-CDC infusion caused a striking hypercholeresis in the hamster (108 microliters bile/mumol bile acid in bile) and in the rat (220 microliters/mumol); these values for bile acid-dependent flow far exceed those reported for any other natural bile acid to date in these species. The induced hypercholeresis was of canalicular origin and was accompanied by an enrichment in bicarbonate ion concentration as well as increased bicarbonate output. The taurine conjugate of nor-CDC did not display hypercholeretic properties in the hamster. In the guinea pig, whose native bile is bicarbonate-rich relative to other species, nor-CDC was only mildly hypercholeretic relative to CDC and caused no change in bicarbonate concentration. Thus shortening the side chain of a natural dihydroxy bile acid by a single carbon atom formed a compound that underwent a different hepatic biotransformation than that of most natural bile acids and induced a bicarbonate-rich canalicular choleresis far greater than that which can be explained by current theories of bile formation.

Animals↗
PubMedDate not supplied

Successful treatment of postoperative external biliary fistulas by endoscopic sphincterotomy.

External biliary fistulas occur as a complication of biliary tract surgery. Until recently, excision of the fistula was the primary therapeutic modality. We describe seven cases of postoperative external biliary fistula successfully treated by endoscopic papillotomy. Fistulation occurred in four patients after operations for hydatid cysts of the liver, in one patient after cholecystectomy for acute cholecystitis, in one patient with carcinoma of the periampullary region after a decompression procedure, and in the remaining patient after an intraoperative biopsy of a carcinoma of the gallbladder. Endoscopic sphincterotomy is a reliable and effective therapeutic alternative in patients with external biliary fistulas.

Biliary Fistula↗
PubMed1991

Spontaneous external biliary fistula uncomplicated by gallstones.

External biliary fistulae are rare. Only 65 cases have been reported in the literature and in each instance gallstones were a complicating factor. We report in this paper the first case of spontaneous external (cholecystocutaneous) biliary fistula uncomplicated by gallstones.

Aged↗
PubMed1994

Modern concepts in nonsurgical management of traumatic biliary fistulas.

The management of traumatic biliary fistulas is controversial. New ideas in nonsurgical treatment have recently evolved, in part because of the rapid advancement of laporoscopic surgery. Three major concepts are important in managing biliary fistulas: diagnosis, drainage, and decompression. These concepts were applied to a trauma patient, then reviewed in detail.

Adult↗