title: Management of acquired bronchobiliary fistula: A systematic literature review of 68 cases published in 30 years.
abstract: OBJECTIVE
  To outline the appropriate diagnostic methods and therapeutic options for acquired bronchobiliary fistula (BBF).
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China.
authors: Guan-Qun
authors: GQ
authors: Liao
authors: Hao
authors: H
authors: Wang
authors: Guang-Yong
authors: GY
authors: Zhu
authors: Kai-Bin
authors: KB
authors: Zhu
authors: Fu-Xin
authors: FX
authors: Lv
authors: Sheng
authors: S
authors: Tai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001658:Biliary Fistula / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D001983:Bronchial Fistula / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult