Diagnosis and personalized management of cholecystoduodenal fistula
10.3760/cma.j.issn.1007-8118.2013.01.017
- VernacularTitle:胆囊胆管十二指肠瘘的诊断及个体化治疗22例报告
- Author:
Qiwen YE
;
Linli LI
;
Daichang ZHANG
;
Wenfeng ZHAN
;
Feng LIN
;
Yisheng HUANG
- Publication Type:Journal Article
- Keywords:
Biliary tract;
Intestinal fistula;
Biliary fistula
- From:
Chinese Journal of Hepatobiliary Surgery
2013;(1):55-57
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the factors which could lead to a preoperative diagnosis and to guide the management of cholecystoduodenal fistula (CDF).Method The experience on the diagnosis and treatment of 22 patients with CDF were retrospectively studied.These patients came from 1242 patients who received biliary tract operation in our hospital from 2001 to 2012.Results 64％ (14 of 22 patients) had 3 out of 5 of the following symptoms/signs:(1) symptoms of recurrent chills and fever,with no or only mild jaundice; (2) significant atrophy or disappearance of gallbladder on computed tomography (CT) ; (3) CT revealed complex anatomy in right upper abdomen with dilated loops of bowel; (4) ultrasound or CT revealed pneumobilia or pneumo-gallbladder; (5) barium study or duodenal endoscopy revealed obvious deformation in duodenal bulb or abnormal opening.There was no perioperative death.Morbidities included biliary fistula which presented on postoperative day 6 and day 7 in 2 patients,respectively.The daily volume of bile drainage was about 500 ml,and the biliary fistula healed after a month of conservative treatment.In addition,there were 6 patients who had infected wound,8 patients with right pleural effusion,and 8 patients with residual calculi.There was no intestinal fistula or biliary stricture.Conclusions Careful preoperative history taking and CT/uhrasound studies significantly improved the diagnostic rate of CDF.Individualized treatment reduced complications and improved clinical results.
