AIM: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 1980August 2010)usin...AIM: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 1980August 2010)using the following keywords:biliobronchial fistula,bronchobiliary fistula,bronchobiliary fistula,biliarybronchial fistula,tracheobiliary fistula,hepatobronchial fistula,bronchopleural fistula,and biliptysis.Further articles were identified through crossreferencing.RESULTS:Sixtyeight 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 lessinvasive 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 followup period in 28 cases(range,2 wk to 72 mo),and the recovery rate was 87.7%(57/65).CONCLUSION: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 noninvasive methods failed.展开更多
文摘AIM: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 1980August 2010)using the following keywords:biliobronchial fistula,bronchobiliary fistula,bronchobiliary fistula,biliarybronchial fistula,tracheobiliary fistula,hepatobronchial fistula,bronchopleural fistula,and biliptysis.Further articles were identified through crossreferencing.RESULTS:Sixtyeight 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 lessinvasive 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 followup period in 28 cases(range,2 wk to 72 mo),and the recovery rate was 87.7%(57/65).CONCLUSION: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 noninvasive methods failed.