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At least 19 recordsLinked to original sources
PubMed1975

External biliary fistula.

External biliary fistulas, once common, are now rare: before the present report of 4 cases only 27 cases have been reported in the English literature since 1900. Review of the records of four patients with external biliary fistula confirmed its occurrence in patients over 50 years of age and the variable site for operning of the fistulous tract. Cholecystectomy provided successful treatment in three of the four patients but the fourth was too ill to undergo an operation; in general, definitive treatment is cholecystectomy, together with excision of the fistulous tract if this takes a direct path through the abdominal wall from the gallbladder, or curettage if the course is devious.

Aged↗
PubMed1977

[Complication of spontaneous internal biliary fistulae (experiences in 46 cases)].

Spontaneous internal biliary fistulas are complications of biliary disease and may themselves be the source of further complications. Instances of the latter observed in a series of 28 bilio-digestive and 18 bilio-biliary forms are described: angiocolitis, biliary peritonitis, cholangitic cirrhosis, diarrhoea and malabsorption syndrome, haemorrhage, biliary ileus and Bouveret syndrome. Stress is laid on the need for early diagnosis and early surgery. It is pointed out that there is no such thing as an innocuous biliary calculus.

Aged↗
PubMed1975

Copper metabolism after biliary fistula, obstruction, or sham operation in rats.

Intravenously administered carrier-free 67Cu appeared rapidly in the bile of rats with a recently created biliary fistula; maximal excretion occurred within the first 2 hours. However, if the biliary fistula had been created 3 or 4 days before injection of the 67Cu, only one-fourth to one-half as much of the isotope appeared in the bile. There also was a small decrease in stable biliary copper. When rats with biliary fistula were compared with rats with permanent biliary obstruction, over a period of 6 weeks, both exhibited a marked increase in plasma copper and an equally pronounced increase in the rho-phenylenediamine oxidase activity of plasma but no increase in hepatic copper. Peaks in blood were reached within 2 weeks and then slowly diminished. Sham-operated rats had parallel, but much lower, copper and enzyme changes. Correlations between these rat studies and the copper retention of Wilson's disease and of primary biliary cirrhosis are suggested.

Animals↗
PubMed1975

Excretion of methylproscillaridin in patients with a biliary fistula.

Four patients with a biliary fistula received 0.5 mg 3H-methylproscillaridin as a single oral dose. 55% of the dose was excreted in bile, 16% in urine and 3% in faeces. More than 60% of the radioactivity excreted in bile and urine appeared within the first 24 hours. 78% of the radioactivity in bile consisted of CHCl3-insoluble metabolites of methylproscillaridin, incubation of which with beta-glucuronidase led to splitting off glucuronic acid from almost 80%. Methylproscillaridin can be regarded as the principal conjugated compound. TLC-separation of CHCl3-soluble compounds from bile showed identical running of radioactivity with methylproscillaridin, proscillaridin and scillarenin and three unknown metabolites P1, P2, and P3. In urine the CHCl3-soluble fraction averaged 16% to 34% of the total amount and was identified as methylproscillaridin, proscillaridin, scillarenin, P2 and P3. The relative composition of the total radioactivity in faeces amounted to 77% methylproscillardidin, 4% scillarenin and 12% polar metabolites.

Aged↗
PubMed1975

Spontaneous internal biliary fistulas.

Etiology, diagnostic investigations and surgical procedures on 58 patients with spontaneous internal biliary fistulas are reported. Cholelithiasis and peptic ulcer were found to be the presumptive cause of fistula respectively in 53 and five patients. Preoperative diagnosis was established on 31 patients while in the remaining 27 fistula was found incidentally at surgery. Surgical treatment included a wide variety of operations which were performed on the basis of the pathologic features of fistula. Over all mortality rate was 5 percent and morbidity 13 percent. The unsatisfactory results of the surgical treatment of internal biliary fistulas are another strong argument for performing early cholecystectomy in all the patients with cholelithiasis.

Adult↗
PubMed1977

[Diagnosis and treatment of internal biliary fistulas].

In the paper the diagnostic and therapeutic policy employed in 11 patients with internal biliary fistulas, most frequently caused by cholelithiasis, is analysed. Some aspects of the preoperative diagnosis are eluciadated, and it is concluded that patients with internal biliary fistulas are to be treated surgically: cholecystectomy, suturing of defects in the gastric and intestinal wall, the drainage of bile tracts.

Aged↗
PubMedDate not supplied

[Spontaneous internal biliary fistula. Review of the literature].

The literature concerning internal biliary fistula is reviewed. Its frequency in autopsy ranges from 0.4 to 5%, and in biliary tract operations from 0.4 to 7%. A general approach has to be established in order to obtain a diagnosis, and an individually oriented treatment provided. Emphasis is placed on certain measures of treatment and complications. The most severe complications are cholangitis (7.5%) and gall stone ileus (2% to 6%).

Biliary Fistula↗
PubMed1978

Spontaneous external biliary fistula in a patient with heroin addiction.

Spontaneous external biliary fistula, once common, is now a rare clinical entity. A patient with this lesion is described and attention is drawn to the fact that this rare condition is still being seen in certain patients with neglected cholecystitis. Heroin addiction was thought to have modified his response to gallbladder disease and contributed to the perforation. Diagnosis was suspected on physical examination and confirmed by spontaneous discharge of stones and fistulogram.

Biliary Fistula↗
PubMed1992

Successful treatment of postoperative external biliary fistula by selective nasobiliary drainage.

A 25-year old man presented with a high output external biliary fistula after an operation for a giant hydatid cyst of the liver. Endoscopic sphincterotomy was inadequate to close the fistula. A nasobiliary tube was selectively inserted into the leaking hepatic duct and bile was continuously aspirated. The fistula and the residual cavity healed completely. Details of the patients' management using this alternative technique, are discussed.

Adult↗
PubMedDate not supplied

[Our experience with the treatment of cavitary and external biliary fistulas following surgical operations for hepatic echinococcosis].

Successful treatment of five personal cases of external cavitary and biliary fistulae following radical liver hydatid surgery is reported. Stress is laid on the fact that complications may still occur, even when the latest techniques are employed. These can be avoided if the pathological anatomy and biliary physiopathology associated with the disease are fully understood, so that techniques can be adjusted to the different situations revealed by pre- and intraoperative exploration. Medical or surgical management must be preceded by precise knowledge of the reasons for persistence of the fistula.

Adult↗
PubMedDate not supplied

Functional modifications of endocrine pancreas after internal biliary fistula (experimental research).

The function of the B-insular system has been explored in dogs total internal biliary fistula (cholecysto-jejunostomy after closure of the common bile duct), an operation which causes an increase in number and total volume of pancreatic islets. Two groups of 10 animals each were either submitted to operation or used as controls. The endocrine function of the pancreas was explored 45-60 cays after surgery by assessing basal blood glucose and serum insulin. IVGTT and i.v. tolbutamide test were performed subsequently. The results indicate that in operated animals the ability to release insulin after stimulation is increased and that the control of basal hormone secretion is fully preserved.

Animals↗
PubMed1977

Chronic bile duct cannulation of rhesus macaques (Macaca mulatta) without causing biliary fistulas.

Two surgical procedures were used for establishing chronic bile duct cannulations in rhesus macaques (Macaca mulatta) while maintaining an intact enterohepatic circulation for use in metabolism studies. One procedure resulted in the formation of biliary fistulas in all of the animals, whereas the other procedure allowed successful maintenance of the macaques without fistulation for up to 8 months after surgery. The possible importance of pressure against bile outflow in the development of the fistulas was discussed.

Animals↗
PubMed1977

Studies on digitalis. XII. Kinetic pattern of digitoxin metabolism in patients with biliary fistulas.

The metabolic pattern of cardioactive and inactive, conjugated metabolites (a maximum of 24 substances) was studied after a single intravenous dose of 0.6 mg digitoxin in two female patients (aged 72 and 62 yr) with biliary fistulas. Bile and urine were collected every twenty-fourth hour and the 1-, 2-, 4-, 6-, and 8-day samples were analyzed. With the methods used, enzymatic cleavage of conjugation bonds, TLC (thin-layer chromatography), and a modified 86Rb method, the products of hydroxylation, hydrolysis, and conjugation could be separated. All cardioactive metabolites were present in bile and all were conjugated. Unchanged digitoxin was the main substance excreted. Hydrolyzed and conjugated metabolites formed a greater part of the substances excreted in bile than hydroxylated metabolites. The metabolic pattern in bile did not change much with time. The metabolic pattern in urine showed no close resemblance to that in bile. Hydroxylated, hydrolyzed, and conjugated metabolites were equally predominant in urine. Interruption of the enterohepatic circulation by T tube drainage not only changed the elimination kinetics of digitoxin but also changed the pattern of digitoxin metabolites in urine.

Adult↗
PubMed1978

[Conservative treatment of hepaticocholedochus stones via external biliary fistulae].

The experience with non-surgical treatment of retained stones in 13 patients is described. The treatment was successful in 8 cases. The method of dissolution of the stones and their mechanical removal with the help of a lithotrap of own design was used. The conclusion is drawn, that the treatment of the patients with gallstones in presence of external biliary fistulas should start from conservative methods.

Biliary Fistula↗