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      Management of acquired bronchobiliary fistula: A systematic literature review of 68 cases published in 30 years.

      World journal of gastroenterology : WJG

      Adolescent, Adult, Aged, Aged, 80 and over, Biliary Fistula, diagnosis, etiology, pathology, therapy, Bronchial Fistula, Databases, Factual, Female, Humans, Male, Middle Aged, Treatment Outcome, Young Adult

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          Abstract

          To outline the appropriate diagnostic methods and therapeutic options for acquired bronchobiliary fistula (BBF). Literature searches were performed in Medline, EMBASE, PHMC and LWW (January 1980-August 2010) using the following keywords: biliobronchial fistula, bronchobiliary fistula, broncho-biliary fistula, biliary-bronchial fistula, tracheobiliary fistula, hepatobronchial fistula, bronchopleural fistula, and biliptysis. Further articles were identified through cross-referencing. Sixty-eight cases were collected and reviewed. BBF secondary to tumors (32.3%, 22/68), including primary tumors (19.1%, 13/68) and hepatic metastases (13.2%, 9/68), shared the largest proportion of all cases. Biliptysis was found in all patients, and other symptoms were respiratory symptoms, such as irritating cough, fever (36/68) and jaundice (20/68). Half of the patients were treated by less-invasive methods such as endoscopic retrograde biliary drainage. Invasive approaches like surgery were used less frequently (41.7%, 28/67). The outcome was good at the end of the follow-up period in 28 cases (range, 2 wk to 72 mo), and the recovery rate was 87.7% (57/65). The clinical diagnosis of BBF can be established by sputum analysis. Careful assessment of this condition is needed before therapeutic procedure. Invasive approaches should be considered only when non-invasive methods failed.

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          Journal
          10.3748/wjg.v17.i33.3842
          3181447
          21987628

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