胆管支气管瘘的诊断和治疗

Diagnosis and treatment of bronchobiliary fistula

探讨胆管支气管瘘的诊断和治疗方法。结合2例胆管支气管瘘病人的诊治经过，结合文献资料探讨胆管支气管瘘病因、症状、诊断、治疗方法及预后。胆管支气管瘘病因众多，肝或肺包虫病、阿米巴肝脓肿、细菌性肝脓肿、膈下脓肿及胆道结石均是重要原发病，医源性胆管支气管瘘值得注意；胆管支气管瘘最重要症状是胆汁样痰；结合原发病、影像学及临床表现诊断一般不难；内镜或介入方法胆管引流可治疗胆管支气管瘘，反复发作或经久不愈者需行手术治疗。胆汁样痰是胆管支气管瘘的特征症状，发生胆管支气管瘘处理需迅速及时。

To explore the diagnosis and treatment modalities of bronchobiliary fistula （BBF）. 2 cases of bronchobiliary fistula were reviewed. The etiology, clinical presenta tions, diagnosis methods, treatment modalities and progno sis of BBF were studied. BBF can be caused by many diseases, which include liver or lung hydatid cyst, amoebic or bacterial liver abscess, subphrenie abscess and biliary lithiasis. Iatrogenic BBF is increasing in recent days. The charac- teristic presentation of BBF is recurrent bilioptysis. Diagnosis of BBF is not very difficult with the primary disease, characteristic clinical presentations and image studies. Treatment modalities of BBF include endoscopic drainage, biliary stent or biliary decompression, and surgery. Bilioptysis is the characteristic presentation of BBF. Treatment of BBF should be immediately and appropriated while the diagnosis confirmed.