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Case Reports in Surgery 2016Internal biliary fistula is a rare complication of a common surgical disease, cholelithiasis. It is seen in 0.74% of all biliary tract surgeries and is thought to be a...
Internal biliary fistula is a rare complication of a common surgical disease, cholelithiasis. It is seen in 0.74% of all biliary tract surgeries and is thought to be a result of repeated inflammatory periods of the gallbladder. In this report we present a case of incomplete cholecystogastric and cholecystoduodenal fistulae in a single patient missed by ultrasonography and endoscopic retrograde cholangiopancreatography and diagnosed intraoperatively. In the literature there is only one report of an incomplete cholecystogastric fistula. To our knowledge this is the first case of double incomplete internal biliary fistulae.
PubMed: 26904348
DOI: 10.1155/2016/5108471 -
European Journal of Medical Research Oct 2022Biliary fistula is a common but serious complication after radical resection of hilar cholangiocarcinoma. We aimed to evaluate the influencing factors of biliary fistula...
BACKGROUND
Biliary fistula is a common but serious complication after radical resection of hilar cholangiocarcinoma. We aimed to evaluate the influencing factors of biliary fistula after radical resection, to provide insights to the clinical treatment of hilar cholangiocarcinoma.
METHODS
Patients undergoing radical resection of hilar cholangiocarcinoma from January 1, 2015 to March 31, 2022 were selected. Patients' personnel characteristics and laboratory test results of patients with and without biliary fistula were collected and compared. Logistic regression analyses were conducted to evaluate the associated risk factors of biliary fistula.
RESULTS
160 patients undergoing radical resection of hilar cholangiocarcinoma were included, the incidence of postoperative biliary fistulas was 20.63%. There were significant differences in the age, preoperative cholangitis and number of biliary anastomosis between biliary fistula and no biliary fistula patients (all p < 0.05). There were significant differences in the gamma glutamyl transpeptidase (GGT) on the first day after surgery, Klebsiella pneumoniae between biliary fistula and no biliary fistula patients (all p < 0.05). Logistic regression analysis indicated that age ≥ 65 years (OR 2.035, 95%CI 1.131-3.007), preoperative cholangitis (OR 1.584, 95% CI 1.081-2.361), number of biliary anastomosis ≥ 2(OR 2.866, 95%CI 1.942-3.624), GGT on the first day after surgery ≥ 120 U/L (OR 1.823, 95%CI: 1.274-2.906), preoperative bile culture for Klebsiella pneumoniae (OR 3.181, 95%CI: 2.426-3.992) were the risk factors of postoperative biliary fistulas (all p < 0.05).
CONCLUSIONS
There are many independent risk factors for postoperative biliary fistula in patients undergoing radical resection of hilar cholangiocarcinoma. Clinical medical workers should take early interventions and treatment measures for these high-risk patients to reduce the occurrence of postoperative biliary fistula.
Topics: Humans; Aged; Klatskin Tumor; Bile Ducts, Intrahepatic; Cholangiocarcinoma; Bile Duct Neoplasms; Retrospective Studies; Postoperative Complications; Cholangitis; Treatment Outcome
PubMed: 36307886
DOI: 10.1186/s40001-022-00851-4 -
Current Cardiology Reviews 2021Biliary pericardial tamponade (BPT) is a rare form of pericardial tamponade, characterized by yellowish-greenish pericardial fluid upon pericardiocentesis. Historically,... (Review)
Review
BACKGROUND
Biliary pericardial tamponade (BPT) is a rare form of pericardial tamponade, characterized by yellowish-greenish pericardial fluid upon pericardiocentesis. Historically, BPT reported to occur in the setting of an associated pericardiobiliary fistula. However, BPT in the absence of a detectable fistula is extremely rare.
LEARNING OBJECTIVE
A biliary pericardial tamponade is a rare form of tamponade warranting a prompt workup (e.g., MRCP or HIDA scan) for a potential fistula between the biliary system and the pericardial space. A pericardio-biliary fistula can be iatrogenic or traumatic. People with a history of chest wall trauma, abdominal surgery, or chest surgery are at increased risk. The use of HIDA scanning plays a salient role in effectively surveilling for the presence of a fistula - especially when MRCP is contraindicated.
CASE PRESENTATION
A 75-year-old Hispanic male presenting with dyspnea and diagnosed with cardiac tamponade is the subject of the study. Subsequent pericardiocentesis revealed biliary pericardial fluid (bilirubin of 7.6 mg/dl). The patient underwent extensive workup to identify a potential fistula between the hepatobiliary system and the pericardial space, which was non-revealing. The mechanism of bile entry into the pericardial space remains to be unidentified.
LITERATURE REVIEW
A total of six previously published BPT were identified: all were males, with a mean age of 53.3 years (range: 31-73). Mortality was reported in two out of the six cases. The underlying etiology for pericardial tamponade varied across the cases: incidental pericardio-biliary fistula, traumatic pericardial injury, and presence of associated malignancy. - Conclusion: Biliary pericardial tamponade is a rare form of tamponade that warrants a prompt workup (e.g., Hepatobiliary Iminodiacetic Acid - HIDA scan) for an iatrogenic vs. traumatic pericardio- biliary fistula. As a first case in the literature, our case exhibits a biliary tamponade in the absence of an identifiable fistula.
Topics: Adult; Aged; Biliary Tract Diseases; Cardiac Tamponade; Dyspnea; Female; Humans; Male; Middle Aged; Pericardiocentesis
PubMed: 32525780
DOI: 10.2174/1573403X16666200611132045 -
Frontiers in Surgery 2023Peptic ulcer disease (PUD) is a very common condition, with an annual incidence ranging from 0.1% to 0.3% and a lifetime prevalence ranging from 5% to 10%. If not... (Review)
Review
Peptic ulcer disease (PUD) is a very common condition, with an annual incidence ranging from 0.1% to 0.3% and a lifetime prevalence ranging from 5% to 10%. If not treated, it can lead to severe complications such as gastro-intestinal bleeding, perforation, or entero-biliary fistula. Entero-biliary fistulas and especially choledocho-duodenal fistula (CDF) are a rare, but relevant and important diagnosis, which can lead to several complications such as gastric outlet obstruction, bleeding, perforation, or recurrent cholangitis. In this article, we present the case of an 85-year-old woman with PUD complicated with gastro-intestinal bleeding and a CDF. We also performed a review of the literature to search for pre-existing cases with this atypical clinical presentation. The aim was to raise awareness among surgeons and clinicians by offering a summary of different types of entero-biliary and especially CDF, existing diagnostic investigations, and management.
PubMed: 37409067
DOI: 10.3389/fsurg.2023.1206828 -
Indian Pediatrics Nov 2018Congenital tracheobiliary fistula is a rare developmental anomaly with a persistent communication between the biliary system and the trachea.
BACKGROUND
Congenital tracheobiliary fistula is a rare developmental anomaly with a persistent communication between the biliary system and the trachea.
CHARACTERISTICS
A 7-day-old baby with severe respiratory distress and aspiration pneumonia.
OUTCOME
Tracheobilliary fistula identified on bronchoscopy. Open surgical excision of fistula was followed by improvement.
MESSAGE
This condition should be considered in the differential diagnosis of intractable aspiration pneumonia.
Topics: Biliary Fistula; Bronchoscopy; Diagnosis, Differential; Humans; Infant, Newborn; Male; Pneumonia, Aspiration; Tomography, X-Ray Computed; Trachea; Tracheal Diseases
PubMed: 30587651
DOI: No ID Found -
Clinical Gastroenterology and... Dec 2019
Topics: Aged, 80 and over; Biliary Fistula; Cholecystectomy; Colectomy; Colon, Ascending; Colonic Diseases; Female; Gallbladder Diseases; Gallstones; Humans; Intestinal Fistula; Intestinal Obstruction; Sigmoid Diseases; Tomography, X-Ray Computed
PubMed: 30710703
DOI: 10.1016/j.cgh.2019.01.031 -
Revista Espanola de Enfermedades... Dec 2022A 77-year-old female with previous medical history of non-cirrhotic chronic hepatitis B and hepatocellular carcinoma treated with sequential partial hepatectomy followed...
A 77-year-old female with previous medical history of non-cirrhotic chronic hepatitis B and hepatocellular carcinoma treated with sequential partial hepatectomy followed by transarterial chemoembolization complained of pruritus and jaundice. Magnetic resonance cholangiopancreatography revealed a peri-hilar ill-defined stenosing lesion suggestive of malignancy. Endoscopic retrograde cholangiopancreatography with cholangioscopy confirmed a circumferential peri-hilar stenosis with fragile mucosa and tortuous dilated vessels and biopsies of this area were consistent cholangiocarcinoma. After 3 months, she presented with new-onset dyspnea and bilioptysis and abdominal computed tomography revealed a bronchial-biliary fistula. ERCP was performed to place a self-expandable metal stent in the biliary tract, which resulted in rapid clinical improvement. The patient has been followed for 2 years and remains globally stable with two episodes of worsening of bilioptysis secondary to stent obstruction by lithiasis that were easily resolved with Fogarty balloon-assisted extraction, with rapid improvement. This case demonstrates the long-term efficacy of endoscopic biliary drainage with self-expandable metallic stent for bronchial-biliary fistula in the setting of cholangiocarcinoma. .
Topics: Female; Humans; Aged; Biliary Fistula; Carcinoma, Hepatocellular; Bile Duct Neoplasms; Stents; Liver Neoplasms; Chemoembolization, Therapeutic; Biliary Tract; Cholangiocarcinoma; Cholangiopancreatography, Endoscopic Retrograde; Bile Ducts, Intrahepatic; Drainage; Cholestasis
PubMed: 35704365
DOI: 10.17235/reed.2022.8970/2022 -
World Journal of Gastroenterology Sep 2011To outline the appropriate diagnostic methods and therapeutic options for acquired bronchobiliary fistula (BBF). (Review)
Review
AIM
To outline the appropriate diagnostic methods and therapeutic options for acquired bronchobiliary fistula (BBF).
METHODS
Literature searches were performed in Medline, EMBASE, PHMC and LWW (January 1980-August 2010) using the following keywords: biliobronchial fistula, bronchobiliary fistula, broncho-biliary fistula, biliary-bronchial fistula, tracheobiliary fistula, hepatobronchial fistula, bronchopleural fistula, and biliptysis. Further articles were identified through cross-referencing.
RESULTS
Sixty-eight cases were collected and reviewed. BBF secondary to tumors (32.3%, 22/68), including primary tumors (19.1%, 13/68) and hepatic metastases (13.2%, 9/68), shared the largest proportion of all cases. Biliptysis was found in all patients, and other symptoms were respiratory symptoms, such as irritating cough, fever (36/68) and jaundice (20/68). Half of the patients were treated by less-invasive methods such as endoscopic retrograde biliary drainage. Invasive approaches like surgery were used less frequently (41.7%, 28/67). The outcome was good at the end of the follow-up period in 28 cases (range, 2 wk to 72 mo), and the recovery rate was 87.7% (57/65).
CONCLUSION
The clinical diagnosis of BBF can be established by sputum analysis. Careful assessment of this condition is needed before therapeutic procedure. Invasive approaches should be considered only when non-invasive methods failed.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biliary Fistula; Bronchial Fistula; Databases, Factual; Female; Humans; Male; Middle Aged; Treatment Outcome; Young Adult
PubMed: 21987628
DOI: 10.3748/wjg.v17.i33.3842 -
Parasite (Paris, France) 2014Cystic echinococcosis (CE) and alveolar echinococcosis (AE) are chronic, complex and neglected diseases. Their treatment depends on a number of factors related to the... (Review)
Review
Cystic echinococcosis (CE) and alveolar echinococcosis (AE) are chronic, complex and neglected diseases. Their treatment depends on a number of factors related to the lesion, setting and patient. We performed a literature review of curative or palliative non-surgical, non-chemical interventions in CE and AE. In CE, some of these techniques, like radiofrequency thermal ablation (RFA), were shelved after initial attempts, while others, such as High-Intensity Focused Ultrasound, appear promising but are still in a pre-clinical phase. In AE, RFA has never been tested, however, radiotherapy or heavy-ion therapies have been attempted in experimental models. Still, application to humans is questionable. In CE, although prospective clinical studies are still lacking, therapeutic, non-surgical drainage techniques, such as PAIR (puncture, aspiration, injection, re-aspiration) and its derivatives, are now considered a useful option in selected cases. Finally, palliative, non-surgical drainage techniques such as US- or CT-guided percutaneous biliary drainage, centro-parasitic abscesses drainage, or vascular stenting were performed successfully. Recently, endoscopic retrograde cholangiopancreatography (ERCP)-associated techniques have become increasingly used to manage biliary fistulas in CE and biliary obstructions in AE. Development of pre-clinical animal models would allow testing for AE techniques developed for other indications, e.g. cancer. Prospective trials are required to determine the best use of PAIR, and associated procedures, and the indications and techniques of palliative drainage.
Topics: Biliary Fistula; Cholangiopancreatography, Endoscopic Retrograde; Cholangitis; Diathermy; Drainage; Echinococcosis; Echinococcosis, Hepatic; High-Intensity Focused Ultrasound Ablation; Humans; Punctures; Radiofrequency Therapy
PubMed: 25531730
DOI: 10.1051/parasite/2014071 -
HPB Surgery : a World Journal of... 1998We report 210 cases of external biliary fistula treated in our clinics between 1970-1992. In 7 cases, fistulas were formed after iatrogenic bile duct injury, in 4 cases...
We report 210 cases of external biliary fistula treated in our clinics between 1970-1992. In 7 cases, fistulas were formed after iatrogenic bile duct injury, in 4 cases after exploration of common bile duct, in 4 cases due to disruption of biliary-intestinal anastomosis, and in 2 cases due to liver trauma. In 85 cases bile leak was observed after cholecystomy, in 103 cases after hydatid disease surgery, and in 4 cases after the passage of P.T.C. catheter. In one patient the appearance of the fistula was due to spontaneous discharge of a gallbladder empyema. 173 cases were managed conservatively, and 37 cases surgically.
Topics: Biliary Fistula; Humans; Postoperative Complications
PubMed: 9515235
DOI: 10.1155/1998/42791