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Journal of Gastrointestinal Surgery :... Jun 2022
Topics: Biliary Fistula; Embolization, Therapeutic; Hemobilia; Hepatic Artery; Humans
PubMed: 35132562
DOI: 10.1007/s11605-021-05118-7 -
Tropical Gastroenterology : Official... 2001A biliary fistula is almost invariably related to gallstone disease and commonly follows a hurried cholecystectomy by an inexperienced surgeon. This catastrophy which is... (Review)
Review
A biliary fistula is almost invariably related to gallstone disease and commonly follows a hurried cholecystectomy by an inexperienced surgeon. This catastrophy which is largely preventable, often necessitates repeated surgical intervention and accrues an estimated 5-year mortality rate approaching 30%. Published series only show a slight increase in the incidence (one per 150-200) after laparoscopic cholecystectomy. The injury results from imprecise dissection and inadequate demonstration of the anatomical structures. The diagnosis is usually obvious and persistent tachycardia and hypotension inspite of an adequate intravenous infusion and a normal central venous pressure is another well known indicator of subhepatic collection of bile, which indicates an urgent ultrasonographic scanning of the upper abodmen. ERCP is a useful diagnostic and therapeutic tool when the continuity of the extra-hepatic biliary system has not been disrupted. An endobiliary stent can be placed across the defect in the same sitting, to tide over the immediate crisis and perhaps treat the patient on a permanent basis. Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive technique of outlining both the intra and extrahepatic biliary tree, which can provide a better road map of the fistula than an ERCP. The management has to be tailored to the patient's condition and the expertise available. A bilio-enteric anastomosis, performed 4 to 6 months after the initial surgery on a dilated common hepatic duct is more likely to succeed than an operation on a septic, hypoproteinemic patient with sodden, friable, non-dilated bile ducts. On the other hand, waiting for the ducts to dilate in a patient with a complete transection of the bile ducts with complete biliary diversion only leads to depletion of the bile acid pool, severe electrolyte derangement and nutritional failure, leading on to sepsis and death.
Topics: Bile Duct Diseases; Biliary Fistula; Cholecystectomy; Humans; Postoperative Complications
PubMed: 11681114
DOI: No ID Found -
ANZ Journal of Surgery Mar 2022
Topics: Biliary Fistula; Cutaneous Fistula; Gallbladder Diseases; Humans
PubMed: 34324781
DOI: 10.1111/ans.17100 -
Clinical Gastroenterology and... Oct 2011
Topics: Aged, 80 and over; Biliary Fistula; Biliary Tract; Colon; Humans; Intestinal Fistula; Male; Radiography, Abdominal
PubMed: 21600303
DOI: 10.1016/j.cgh.2011.04.015 -
Journal of Vascular and Interventional... Nov 2023
Topics: Humans; Biliary Fistula; Biliary Tract; Pleural Diseases; Drainage
PubMed: 37619939
DOI: 10.1016/j.jvir.2023.08.022 -
Khirurgiia 2023Hepatic artery aneurysms (HAA) are rare (20% of all visceral arteries). Most often, HAAs are asymptomatic and detected at autopsy. However, their ruptures and/or...
Hepatic artery aneurysms (HAA) are rare (20% of all visceral arteries). Most often, HAAs are asymptomatic and detected at autopsy. However, their ruptures and/or bleeding following pressure ulcers in visceral gastrointestinal organs are a significant clinical and diagnostic problem. We present 2 patients with obstructive jaundice and hemobilia. Diagnostics revealed aneurysm of the right hepatic artery with arterio-biliary fistula. Life-threatening hemobilia is a consequence of HAA rupture into biliary system. Endovascular approach is preferable for HAA without clinical manifestations. Awareness of this disease is important for early detection and active surgical intervention before possible complications.
Topics: Humans; Biliary Fistula; Hemobilia; Aneurysm; Hepatic Artery; Jaundice, Obstructive
PubMed: 37850899
DOI: 10.17116/hirurgia202304177 -
Surgery, Gynecology & Obstetrics Oct 1981From 1932 to 1978, 105 patients with biliary enteric fistulas are reported upon from The New York Hospital-Cornell Medical Center. During this 46 year period, 11,808...
From 1932 to 1978, 105 patients with biliary enteric fistulas are reported upon from The New York Hospital-Cornell Medical Center. During this 46 year period, 11,808 patients were operated upon for nonmalignant biliary tract disease, representing an incidence of biliary enteric fistulas of 0.9 per cent. The most common location of the fistula was cholecystoduodenal in 77 per cent and cholecystocolic in 15 per cent. Ninety-eight of the 105 patients underwent 109 surgical procedures for symptoms and complications associated with the fistula. The operative mortality was 6 per cent. The recommended definitive procedure includes cholecystectomy, excision of the fistula, common bile duct exploration and operative cholangiography. Among the 105 patients were 22 who presented with intestinal obstruction or ileus due to gallstones. The operative mortality in this group was 4.5 per cent. The recommended treatment for this condition is operative relief of the obstruction with correction of the biliary enteric fistula at an elective second stage operation.
Topics: Adult; Aged; Biliary Fistula; Cholelithiasis; Duodenal Diseases; Female; Gallbladder Diseases; Humans; Intestinal Obstruction; Middle Aged
PubMed: 7280941
DOI: No ID Found -
Cirugia Espanola Feb 2015
Topics: Biliary Fistula; Cholecystectomy; Female; Humans; Middle Aged; Postoperative Complications; Tomography, X-Ray Computed
PubMed: 25287781
DOI: 10.1016/j.ciresp.2014.08.002 -
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 -
Journal of Vascular and Interventional... Jun 2022
Topics: Biliary Fistula; Biliary Tract; Bronchial Fistula; Embolization, Therapeutic; Humans
PubMed: 35283279
DOI: 10.1016/j.jvir.2022.03.003