Original article| Volume 86, ISSUE 2, P181-187, August 1953

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Biliary fistulas

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      • 1.
        1. A review of fifty-two biliary fistulas discovered at the Boston City Hospital over a twenty-year period is reported.
      • 2.
        2. Twenty-three external biliary fistulas were studied which represented surgical error in judgment or technic.
      • 3.
        3. All the external fistulas were associated with residual biliary disease: gallbladder remnant in eight; stricture, nine; common duct stone, three; biliary intestinal anastomosis, two; cancer of pancreas, one.
      • 4.
        4. Thirty internal biliary fistulas were studied and were found to result from long-standing biliary disease.
      • 5.
        5. Sixteen of the internal fistulas caused gallstone ileus. The preoperative diagnostic features of this ileus are discussed.
      • 6.
        6. The anatomic types of internal biliary fistula were: cholecystoduodenal, eight; cholecystocolic, three; cholecystogastric, one; choledochoduodenal, one; cholecystocholedochal, one. The correct treatment of each is reviewed.
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