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September 1967

Pleurobiliary and Bronchobiliary Fistulas: Surgical Management

Author Affiliations

St. Louis
From the Division of Thoracic and Cardiovascular Surgery, Washington University School of Medicine, St. Louis.

Arch Surg. 1967;95(3):380-386. doi:10.1001/archsurg.1967.01330150056009

TWO UNUSUAL and serious conditions are seen as complications in three categories of disease: (1) trauma; (2) hepatic abscessamebic, echinococcic, or pyogenic; and (3) biliary tract obstructions, both surgical and nonsurgical. The aggregate experience with these problems is not large, so that no one institution or group has seen more than a few cases. Early recognition and proper management of each case is essential, however, since the deleterious effects of intrathoracic bile leave little margin for error. We are reporting this analysis of seven patients referred to the Barnes Hospital Chest Service in the past 15 years to reemphasize the principles of management that must be followed if a successful outcome is to be achieved.

The Table shows the etiology and the type of fistula in these seven cases. Four were due to trauma; three were the result of automobile accidents; and one was the result of a fall. These

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