Surgical Treatment of Biliobiliary and Biliodigestive Fistulas
https://doi.org/10.16931/1995-5464.2016392-100
Abstract
Aim. The study the results of surgical treatment of internal biliary fistulas.
Material and Methods. During the period from 2000 till 2015 fifty nine patients with internal biliary fistulas were examined including 36 cases of Mirizzi syndrome and 23 patients with biliodigestive fistulas.
Results. Mirizzi syndrome type I and type II were observed in 22 and 12 patients respectively. Laparoscopic cholecystectomy was performed in 9 cases (for type I), hepaticojejunostomy with Roux intestinal loop – in 25 cases, choledochoduodenostomy – in 4 cases. In 23 patients with biliodigestive fistulas predominant surgery was the elimination of fistula with hollow organ repair, biliodigestive anastomosis – in 6 cases. 3 patients did not require operation due to
spontaneous recanalization of the fistula.
Conclusion. Mirizzi syndrome and biliodigestive fistulas are rare and complex pathology with difficult early diagnosis. Surgical tactics should be generally limited by reconstructive surgery.
About the Authors
A. V. Vorobey
Belarussian Medical Academy of Postgraduate Education; Republican Centre of Reconstructive Surgical Gastroenterology and Coloproctology
Russian Federation
Doct. of Med. Sci., Professor, Сorrecponding-member; Head of Surgical Department, Director of Republican Centre of Reconstructive Surgical Gastroenterology and Coloproctology
Russian Federation
Doct. of Med. Sci., Professor, Сorrecponding-member; Head of Surgical Department, Director of Republican Centre of Reconstructive Surgical Gastroenterology and Coloproctology
Yu. N. Orlovsky
Belarussian Medical Academy of Postgraduate Education; Republican Centre of Reconstructive Surgical Gastroenterology and Coloproctology
Russian Federation
Russian Federation
Cand. of Med. Sci., Associate Professor, Surgical Department
E. I. Vizhinis
Belarussian Medical Academy of Postgraduate Education; Republican Centre of Reconstructive Surgical Gastroenterology and Coloproctology
Russian Federation
Cand. of Med. Sci., Associate Professor, Surgical Department
Russian Federation
Cand. of Med. Sci., Associate Professor, Surgical Department
A. Ch. Shuleyko
Belarussian Medical Academy of Postgraduate Education; Republican Centre of Reconstructive Surgical Gastroenterology and Coloproctology
Russian Federation
Cand. of Med. Sci., Associate Professor, Surgical Department
Russian Federation
Cand. of Med. Sci., Associate Professor, Surgical Department
References
1. Бедин В.В., Заруцкая Н.В., Пельц В.А. Десятилетний опыт хирургического лечения больных с билиодигестивными и холецистохоледохеальными свищами. Анналы хирургической гепатологии. 2006; 11 (3): 72. Bedin V.V., Zarutskaya N.V., Pel'ts V.A. Ten-year experience of surgical treatment of patients with biliodigestive and cholecysto choledocheal fistulas. Annaly khirurgicheskoy gepatologii. 2006; 11 (3): 72. (In Russian)
2. Тимербулатов В.М., Гарипов P.M., Хунафин С.Н., Нурмухаметов А.А. Внутренние желчные свищи. Современные техно логии в диагностике и лечении. М.: Триада-Х, 2003. 160 с. Timerbulatov V.M., Garipov R.M., Khunafin S.N., Nurmukhametov A.A. Vnutrennie zhelchnie svischi. Sovremennie tehnologii v diagnostike i lechenii [Internal biliary fistulas. Modern technologies in diagnostics and treatment]. Moscow: Triada-X, 2003. 160 p. (In Russian)
3. Топчиашвили З.А., Капров И.Б. Спонтанные внутренние желчные свищи. Тбилиси: Ганатлеба, 1988. 132 с. Topchiashvili Z.A., Kaprov I.B. Spontannie vnutrennie zhelchnie svischi. [Spontaneous internal biliary fistulas]. Tbilisi: Ganatleba, 1988. 132 p. (In Russian)
4. Климов А.Е., Федоров А.Г., Давыдова С.В., Майзельс Е.Н. Выбор оптимального метода лечения больных с синдромом Мириззи. Вестник РУДН. Серия Медицина. 2010; 1: 130–132. Klimov A.E., Fedorov A.G., Davydova S.V., Maizel's E.N. Choosing the best method of treatment of patients with Mirizzi syndrome. Vestnik RUDN. Serija Medicina. 2010; 1: 130–132. (In Russian)
5. Савельев В.С., Ревякин В.И. Синдром Мириззи. Диагностика и лечение. М.: Медицина, 2003. 203 с. Saveliev V.S., Revyakin V.I. Sindrom Mirizzi. Diagnostika i lechenie. [Mirizzi syndrome. Diagnosis and treatment]. Moscow: Medicine, 2003. 203 p. (In Russian)
6. Запорожченко Б.С., Снисаренко А.В., Бородаев И.Е., Горбунов А.А. Синдром Мириззи, диагностика, лечение. Анналы хирургической гепатологии. 2006; 11: 86. Zaporozhchenko B.S., Snisarenko A.V., Borodaev I.E., Gorbunov A.A. Mirizzi syndrome, diagnosis, treatment. Annaly khirurgicheskoy gepatologii. 2006; 11: 86. (In Russian)
7. Гальперин Э.И., Ахаладзе Г.Г., Котовский А.Е. Синдром Мириззи: особенности диагностики и лечения. Анналы хирургической гепатологии. 2006; 11 (3): 7–10. Galperin E.I., Akhaladze G.G., Kotovsky A.E. Mirizzi syndrome: features of diagnosis and treatment. Annaly khirurgicheskoy gepatologii. 2006; 11 (3): 7–10. (In Russian)
Review
For citations:
Vorobey A.V., Orlovsky Yu.N., Vizhinis E.I., Shuleyko A.Ch. Surgical Treatment of Biliobiliary and Biliodigestive Fistulas. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2016;21(3):92-100. (In Russ.) https://doi.org/10.16931/1995-5464.2016392-100
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