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A biliary fistula is a type of fistula in which bile flows along an abnormal connection from the bile ducts into a nearby hollow structure. Types of biliary fistula include: bilioenteric fistula: abnormal connection to small bowel, usually duodenum. thoracobiliary fistula: abnormal connection to pleural space or bronchus (rare).
A surgically created passage between the common bile duct and the jejunum in a procedure called a choledochojejunostomy, can be carried out to relieve the symptoms of biliary obstruction as well as allows the bile duct to drain. [5] In infants with biliary atresia, hepatoportoenterostomy is an alternative method of providing bile drainage.
Some uses for this procedure includes: drainage of bile/infected bile to relieve obstructive jaundice, to place a stent to dilate a stricture in the biliary system, stone removal, and rendezvous technique [4] where guidewire from the common bile duct (CBD) meets with duodenoscope (coming from the oesophagus into the stomach and then duodenum) at the major duodenal papilla.
Cholecystostomy or (cholecystotomy) is a medical procedure used to drain the gallbladder through either a percutaneous or endoscopic approach. The procedure involves creating a stoma in the gallbladder, which can facilitate placement of a tube or stent for drainage, first performed by American surgeon, Dr. John Stough Bobbs, in 1867.
The rationale for this approach is that minute residual bile duct remnants may be present in the fibrous tissue of the porta hepatis and thus provide direct connection with the intrahepatic ductule system to allow bile drainage. [2] This procedure was developed in 1951 by Japanese biliary and hepatic pediatric surgeon Morio Kasai (1922–2008).
It also has better endoscopic access to the biliary tree and more physiologic bile drainage. [8] CDD is used in the treatment of biliary obstruction caused by various factors shown below or when alternative treatment options were not accessible. Other less common indications include operative injuries, or chronic dilation of the CBD. [6]