Diagnosis and Treatment of Biliary Fistulas in the Laparoscopic Era

Biliary fistulas are rare complications of gallstone. They can affect either the biliary or the gastrointestinal tract and are usually classified as primary or secondary. The primary fistulas are related to the biliary lithiasis, while the secondary ones are related to surgical complications. Laparo...

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Main Authors: M. Crespi, G. Montecamozzo, D. Foschi
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2016/6293538
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author M. Crespi
G. Montecamozzo
D. Foschi
author_facet M. Crespi
G. Montecamozzo
D. Foschi
author_sort M. Crespi
collection DOAJ
description Biliary fistulas are rare complications of gallstone. They can affect either the biliary or the gastrointestinal tract and are usually classified as primary or secondary. The primary fistulas are related to the biliary lithiasis, while the secondary ones are related to surgical complications. Laparoscopic surgery is a therapeutic option for the treatment of primary biliary fistulas. However, it could be the first responsible for the development of secondary biliary fistulas. An accurate preoperative diagnosis together with an experienced surgeon on the hepatobiliary surgery is necessary to deal with biliary fistulas. Cholecystectomy with a choledocoplasty is the most frequent treatment of primary fistulas, whereas the bile duct drainage or the endoscopic stenting is the best choice in case of minor iatrogenic bile duct injuries. Roux-en-Y hepaticojejunostomy is the extreme therapeutic option for both conditions. The sepsis, the level of the bile duct damage, and the involvement of the gastrointestinal tract increase the complexity of the operation and affect early and late results.
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spelling doaj-art-70fbe56d04c149a8bfbd2d48849860e72025-08-20T03:33:58ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/62935386293538Diagnosis and Treatment of Biliary Fistulas in the Laparoscopic EraM. Crespi0G. Montecamozzo1D. Foschi2II Unit of General Surgery, Luigi Sacco Hospital, Department of Biochemical Sciences L. Sacco, University of Milan, Via G.B. Grassi 74, 20157 Milan, ItalyII Unit of General Surgery, Luigi Sacco Hospital, Department of Biochemical Sciences L. Sacco, University of Milan, Via G.B. Grassi 74, 20157 Milan, ItalyII Unit of General Surgery, Luigi Sacco Hospital, Department of Biochemical Sciences L. Sacco, University of Milan, Via G.B. Grassi 74, 20157 Milan, ItalyBiliary fistulas are rare complications of gallstone. They can affect either the biliary or the gastrointestinal tract and are usually classified as primary or secondary. The primary fistulas are related to the biliary lithiasis, while the secondary ones are related to surgical complications. Laparoscopic surgery is a therapeutic option for the treatment of primary biliary fistulas. However, it could be the first responsible for the development of secondary biliary fistulas. An accurate preoperative diagnosis together with an experienced surgeon on the hepatobiliary surgery is necessary to deal with biliary fistulas. Cholecystectomy with a choledocoplasty is the most frequent treatment of primary fistulas, whereas the bile duct drainage or the endoscopic stenting is the best choice in case of minor iatrogenic bile duct injuries. Roux-en-Y hepaticojejunostomy is the extreme therapeutic option for both conditions. The sepsis, the level of the bile duct damage, and the involvement of the gastrointestinal tract increase the complexity of the operation and affect early and late results.http://dx.doi.org/10.1155/2016/6293538
spellingShingle M. Crespi
G. Montecamozzo
D. Foschi
Diagnosis and Treatment of Biliary Fistulas in the Laparoscopic Era
Gastroenterology Research and Practice
title Diagnosis and Treatment of Biliary Fistulas in the Laparoscopic Era
title_full Diagnosis and Treatment of Biliary Fistulas in the Laparoscopic Era
title_fullStr Diagnosis and Treatment of Biliary Fistulas in the Laparoscopic Era
title_full_unstemmed Diagnosis and Treatment of Biliary Fistulas in the Laparoscopic Era
title_short Diagnosis and Treatment of Biliary Fistulas in the Laparoscopic Era
title_sort diagnosis and treatment of biliary fistulas in the laparoscopic era
url http://dx.doi.org/10.1155/2016/6293538
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