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Cirugia Y Cirujanos 2021Biliopleural fistula is a rare communication between the biliary system and the pleural space secondary to ruptured hydatid cysts, hepatobiliary surgeries or penetrating...
BACKGROUND
Biliopleural fistula is a rare communication between the biliary system and the pleural space secondary to ruptured hydatid cysts, hepatobiliary surgeries or penetrating wounds. There is not so much of the subject in the literature, so there is no standardized protocol for its management.
OBJECTIVE
The objective of this work is to determine advantages and disadvantages of the use of ERCP as a conservative initial treatment for biliopleural fistulas.
METHOD
Our retrospective study included patients with a diagnosis of biliopleural fistula who underwent ERCP as initial treatment, older than 18 years in a period from August 2016 to August 2019.
RESULTS
Eight patients with a diagnosis of biliopleural fistula were included, 75% men and 25% women with a mean age of 24.5 years; the traumatic etiology was predominant in our group (89%), the diagnosis was made between days 3 and 14 after chest tube placement and we were successful in treating the fistula with ERCP in 87.5% of our patients.
CONCLUSIONS
The use of ERCP as initial treatment for biliopleural fistula should be considered as the initial tool in the algorithm of management of this entity.
Topics: Adult; Biliary Fistula; Chest Tubes; Cholangiopancreatography, Endoscopic Retrograde; Female; Humans; Male; Retrospective Studies; Sphincterotomy, Endoscopic; Young Adult
PubMed: 33498074
DOI: 10.24875/CIRU.20000055 -
Revista Espanola de Enfermedades... Apr 2012
Topics: Aged, 80 and over; Biliary Fistula; Bronchial Fistula; Gallbladder Diseases; Humans; Male
PubMed: 22537370
DOI: 10.4321/s1130-01082012000400007 -
Revista Espanola de Enfermedades... Dec 2023A case of a patient with symptoms of gastric obstruction secondary to cholecystogastric fistula is presented and a brief review of the literature is done. (Review)
Review
A case of a patient with symptoms of gastric obstruction secondary to cholecystogastric fistula is presented and a brief review of the literature is done.
Topics: Humans; Endosonography; Biliary Fistula; Gallbladder Diseases; Gastric Fistula
PubMed: 37771296
DOI: 10.17235/reed.2023.9915/2023 -
Journal of Gastrointestinal Oncology Feb 2023Nowadays, the incidence of perihilar cholangiocarcinoma (PHCC) is increasing yearly, and biliary fistula is a common complication. However, there are few reports on the...
The risk factors of biliary fistula after radical resection of perihilar cholangiocarcinoma in elderly patients and its influence on prognosis: a retrospective cohort study.
BACKGROUND
Nowadays, the incidence of perihilar cholangiocarcinoma (PHCC) is increasing yearly, and biliary fistula is a common complication. However, there are few reports on the factors affecting the occurrence of biliary fistula. This study aimed to analyze the risk factors for the occurrence of biliary fistula after radical surgery for PHCC in elderly patients to provide a reference basis for improving the prognosis.
METHODS
From April 2016 to April 2021, we randomly included 250 elderly patients with pathologically diagnosed PHCC. Based on our established inclusion and exclusion criteria, we included 211 patients finally Bile drainage for 3 consecutive days after abdominal drainage or single bile drainage ≥100 mL/d was used as the diagnostic criteria for biliary fistula. Multiple logistic regression was used to analyze the independent risk factors for biliary fistula after radical surgery for PHCC. Besides, the Prognostic Score (PS), the Karnofsky performance score (KPS), and the quality of life (QOL) score were used to assess the patients' postoperative recovery, and survival curves were drawn to reflect their 1-year survival rate, using overall survival.
RESULTS
The statistical results showed a 36.5% incidence of biliary fistula. Our study showed that preoperative cholangitis, number of biliary anastomoses, etc. were independent risk factors for grade B and grade C biliary fistula. Besides, the presence of intraoperative hemorrhage (OR =0.223, P=0.006) and γ-glutamyl transpeptidase (γ-GT) on the first postoperative day (OR =1.011, P=0.013) were still independent risk factors for grade B biliary fistula, while C-reactive protein (CRP) (OR =1.026, P=0.011) and total bilirubin (TBil) (OR =0.003, P=1.066) on the first postoperative day and bile duct diameter (OR =0.299, P=0.020) were independent risk factors for grade C biliary fistula. Analysis of variance (ANOVA) showed statistically significant differences (P<0.05) between the three groups in terms of PS (P=0.000), KPS (P=0.001), and QOL scores (P=0.000).
CONCLUSIONS
The incidence of postoperative biliary fistula remains high in elderly patients treated with radical surgery for PHCC and seriously affects their prognosis. Therefore, focusing on the clinical characteristics and risk factors of patients, improving surgical precision and enhancing postoperative patient care to reduce the likelihood of postoperative biliary fistula, thereby prolonging patient life.
PubMed: 36915431
DOI: 10.21037/jgo-23-34 -
Respiratory Medicine Case Reports 2020The biliary bronchial fistula is rare and difficult to treat. Here we report a 49-year-old woman diagnosed with biliary bronchial fistula due to cough with yellow-green...
BACKGROUND
The biliary bronchial fistula is rare and difficult to treat. Here we report a 49-year-old woman diagnosed with biliary bronchial fistula due to cough with yellow-green sputum.
CASE PRESENTATION
this is a typical case of the biliary bronchial fistula with typical symptoms. The position of the abscess cavity below the diaphragm could not be catheter drainage. After anti-infection treatment, yellow-green sputum was reduced. Follow-up showed a good prognosis.
CONCLUSION
biliary bronchial fistula is rare in the clinic, combined with chest and abdomen infection.
PubMed: 32489847
DOI: 10.1016/j.rmcr.2020.101075 -
The Netherlands Journal of Medicine 2006A case is described emphasising rare complication of gallstone disease: the Mirizzi syndrome in which an impacted gallstone in the Hartmann's pouch or cystic duct causes...
A case is described emphasising rare complication of gallstone disease: the Mirizzi syndrome in which an impacted gallstone in the Hartmann's pouch or cystic duct causes common hepatic duct obstruction and by eroding a fistula. Diagnosis is made by endoscopic retrograde cholangiopancreatography and treatment includes cholecystectomy.
Topics: Adult; Biliary Fistula; Cholangiopancreatography, Endoscopic Retrograde; Cholecystectomy; Cholestasis, Extrahepatic; Female; Gallstones; Hepatic Duct, Common; Humans; Syndrome
PubMed: 16929088
DOI: No ID Found -
Cureus Jun 2022Intrapulmonary gallstones and the formation of pleuro-biliary fistula is a rare complication of laparoscopic cholecystectomy. The stones are most commonly found in the...
Intrapulmonary gallstones and the formation of pleuro-biliary fistula is a rare complication of laparoscopic cholecystectomy. The stones are most commonly found in the right lower lobe of the lungs. The symptoms tend to be insidious in nature and can manifest as hemoptysis, irritating cough, and cholelithoptysis years after the procedure. The stones can be removed through lobectomy or may also be treated non-invasively with antibiotics only. Here, we describe a case of a patient who developed hemoptysis and was found to have intrapulmonary gallstones from laparoscopic cholecystectomy and subsequent fistula formation.
PubMed: 35836468
DOI: 10.7759/cureus.25836 -
PLoS Neglected Tropical Diseases Oct 2023Endocystectomy is a conservative surgical approach to managing cystic echinococcosis. Bile leakage is the main complication of this technique. The aim of this study was...
BACKGROUND
Endocystectomy is a conservative surgical approach to managing cystic echinococcosis. Bile leakage is the main complication of this technique. The aim of this study was to evaluate the factors associated with bile leakage and to assess the outcomes and cost efficiency of strategies used to treat bile leakage.
METHODOLOGY/PRINCIPAL FINDINGS
Patients who underwent endocystectomy between 2005 and 2020 were included. The preoperative characteristics, intra- and postoperative outcomes, hospital costs, and cost efficiency (the Diagnosis-Related Group reimbursement minus the overall cost) were evaluated prospectively. A total of eighty patients with 142 cysts were included. Postoperative complications occurred in 17 patients (21%), including 11 patients with bile leakage (type A: 1, type B: 6 and type C: 4 patients, total 13%). Bile leakage was more frequent in patients with preoperative MRI signs of cysto-biliary fistulas or intraoperative visible cysto-biliary fistulas (p = 0.03 and p = 0.04, respectively) and in patients with cysts larger than 8 cm (p = 0.03). Patients with bile leakage who underwent reoperation (type C) had significantly shorter hospital stays (9 vs. 16 days, p<0.01) and better cost efficiency than those who received radiologic or endocscopic interventions (€2,072 vs. -€2,097 p = 0.01). No mortality was observed, and recurrence was seen in two patients.
CONCLUSIONS/SIGNIFICANCE
Endocystectomy is a safe and efficient technique. Preoperative and intraoperative cysto-biliary fistulas and a cyst diameter larger than 8 cm are correlated to postoperative bile leakage. Early operative management of bile leakage reduces hospital stay and improves cost efficiency compared with radiologic or endoscopic treatments.
Topics: Humans; Biliary Fistula; Echinococcosis, Hepatic; Risk Factors; Endoscopy; Cysts; Retrospective Studies
PubMed: 37906617
DOI: 10.1371/journal.pntd.0011724 -
CVIR Endovascular Dec 2020The formation of a hepatic artery pseudoaneurysm in a liver implant is a rare but potentially fatal complication. Fistulization of such pseudoaneurysms into the bile...
Arterio-biliary fistula caused by a hepatic artery pseudoaneurysm in a recently performed liver transplant: successful resolution and long-term liver implant preservation using a covered coronary stent.
BACKGROUND
The formation of a hepatic artery pseudoaneurysm in a liver implant is a rare but potentially fatal complication. Fistulization of such pseudoaneurysms into the bile duct is sporadic. The most common causes of hepatic artery pseudoaneurysm are infection at the anastomosis site, inadequate surgical technique, and an iatrogenic origin due to minimally invasive procedures. Currently, there is no standardized treatment in neither of these complications, with surgery and various endovascular procedures among the alternatives available. None of these therapeutic approaches has demonstrated a significant increase in long-term liver implant preservation.
CASE PRESENTATION
A 56-year-old man with a two-month liver transplant presented with massive upper gastrointestinal bleeding and hemobilia shortly after the performance of an endoscopic retrograde cholangiopancreatography due to the presence of a hepatic artery pseudoaneurysm with fistulization into the bile duct. This case report describes the successful treatment of both complications, the hepatic artery pseudoaneurysm and the arterio-biliary fistula, using a covered coronary stent placed in the hepatic artery. A year and a half after treatment, the patient maintains a preserved liver implant and a patent hepatic artery.
CONCLUSIONS
Treatment of a hepatic artery pseudoaneurysm with fistulization into bile duct using a covered coronary stent allowed the correct repair of the defect, adequate hemorrhage control, and long-term liver implant preservation.
PubMed: 33289857
DOI: 10.1186/s42155-020-00191-6 -
Canadian Medical Association Journal Nov 1975External 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...
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.
Topics: Aged; Biliary Fistula; Cholecystectomy; Female; Humans; Male; Middle Aged
PubMed: 1182633
DOI: No ID Found