External biliary fistulas and acholia syndrome

Complications of surgical treatment of biliary pathology, including mechanical jaundice, include external biliary fistulas. Their formation, in particular spontaneous, is usually preceded by inflammatory changes of gallbladder and ducts or liver with the outcome in suppuration, and the main cause in most cases is cholelithiasis. When the pus bursts through all the layers of the abdominal wall, the bile is expelled simultaneously with the pus or some time later. An external biliary fistula can form after a surgical opening of the pus.