Juxtapapillary choledochoduodenal fistula. Diagnosis and treatment in 19 cases.
Nineteen patients with distal juxtapapillary choledochoduodenal fistula diagnosed by endoscopic retrograde cholangiopancreatography are reported. Eighty-four percent of the patients had undergone previous operations on the biliary tract. Fistula appears to be mostly secondary to common bile duct exploration with rigid probes or to a technical mistake in performing sphincteroplasty. Spontaneous fistula secondary to the passage of a stone into the duodenal lumen may also occur. Common duct stones were responsible for the symptoms in most cases (70%). Endoscopic sphincterotomy showed good results in cholecystectomized patients with stones. Surgery directed to the fistula or biliary by-pass are not recommended. Uncomplicated fistula probably does not require treatment.
Costamagna
G
G
Istituto di Patologia Chirurgica, Università Cattolica del Sacro Cuore, Roma.
Coppola
R
R
Belli
P
P
Masetti
R
R
Magistrelli
P
P
Nuzzo
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001658:Biliary Fistula / Q000000981:diagnostic imaging* / Q000628:therapy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003137:Common Bile Duct Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D004378:Duodenal Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged