Premium
POST‐CHOLECYSTECTOMY EXTERNAL BILIARY FISTULA
Author(s) -
Singh V.,
Kacker L. K.,
Sikora S. S.,
Saxena R.,
Kapoor V. K.,
Kaushik S. P.
Publication year - 1997
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1997.tb01933.x
Subject(s) - medicine , cholecystectomy , biliary fistula , general surgery , fistula , laparoscopic cholecystectomy , surgery
Background : External biliary fistula (EBF) following bile duct injury is a serious complication of cholecystectomy. Methods : From January 1989 to December 1994, 37 patients with post‐cholecystectomy external biliary fistula were seen at this centre. There were 14 partial, 22 complete and one sub‐vesical duct of Luschka injury. Sixteen patients had a controlled EBF at presentation; 10 patients had intra‐abdominal collections and seven patients presented with peritonitis. Results : A staged approach to the management of these patients was adopted in which the initial management aimed at creating a ‘controlled’ fistula. This approach comprised conservative treatment ( n = 9), percutaneous catheter drainage of intra‐abdominal collections ( n = 10), biliary drainage ( n = 6), and surgical intervention ( n = 7). One patient died because of progressive liver failure in spite of intensive management. Definitive management comprised the surgical repair of biliary strictures wherever indicated, after waiting for the acute problems to settle. Conclusions: By adopting a staged approach along with a judicious use of endoscopy, radiology and surgery that were based on clinical circumstances, it was possible to achieve satisfactory results for this otherwise distressing condition.