title: [Internal biliary fistulas--diagnostic and therapeutic problems].
abstract: BACKGROUND
  Internal biliary fistula (IBF) is still a challenging condition. The preoperative diagnosis is established in less than 50% of cases. Treatment is based on individual approach but postoperative morbidity and mortality rates are high.
  
  
  OBJECTIVE
  To study the experince of our clinic in the diagnosis and treatment of IBF's and to make a review of the literature.
  
  
  METHODS
  a retrospective analysis of the data of 7 patients with IBF (0,53% of all surgical interventions on the biliary system during a 4-years period). The preoperative diagnosis was correct in only 2 cases. All the 7 patients were treated surgically.
  
  
  RESULTS
  The early postoperative mortality and morbidity rates were 0% and 42,86% respectively. The data of literature are reviewed and discussed.
  
  
  CONCLUSIONS
  IBS is a rare condition affecting more often women above 65 yrs suffering of gallstones. There are no typival clinical and laboratory data but US, CT-scan, ERCP and MRI might be a 100% informative. Open surgery remains the basic method of treatment.
authors.forename: K
authors.initials: K
authors.lastname: Draganov
authors.forename: V
authors.initials: V
authors.lastname: Dimitrova
authors.forename: E
authors.initials: E
authors.lastname: Zhivkov
authors.forename: D
authors.initials: D
authors.lastname: Rusenov
authors.forename: E
authors.initials: E
authors.lastname: Tosheva
authors.forename: I
authors.initials: I
authors.lastname: Taneva
authors.forename: S
authors.initials: S
authors.lastname: Tonev
mesh_terms: D001658:Biliary Fistula / Q000175:diagnosis / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D004378:Duodenal Diseases / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome