title: Successful internalization of a chronic biliary cutaneous fistula after liver transplantation: deepithelializing the fistula tract.
abstract: Biliary cutaneous fistulas are uncommon sequelae after biliary surgery and can be a source of significant morbidity. We describe a liver recipient who developed a biliary cutaneous fistula secondary to hepatic artery thrombosis; this subsequently drained for over 7 years. Through a novel approach, using the transabdominal fistula tract as a conduit, the fistula skin opening was deepithelialized and anastomosed to a jejunal loop, internally draining the tract. For over 7 years postoperatively, this internal drainage procedure has continued to function effectively. This approach may have value in internalizing longstanding biliary cutaneous fistulas in well-selected patients in whom there is no existing biliary ductal system or the existing system anatomically does not lend itself to restoration of functional internal drainage through conventional approaches.
authors: Division of Plastic and Reconstructive Surgery, Department of Surgery, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI 48202-2689, USA.
authors: David
authors: D
authors: Morris
authors: Daniel
authors: D
authors: Ladizinsky
authors: Marwan
authors: M
authors: Abouljoud
mesh_terms: D001658:Biliary Fistula / Q000209:etiology / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods; D002908:Chronic Disease; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery*; D006499:Hepatic Artery; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013927:Thrombosis / Q000150:complications