[Internal biliary fistulas--diagnostic and therapeutic problems].

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. AIM: To study the experince of our clinic in the diagnosis and treatment of IBF's and to make a review of the literature. MATERIAL AND 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. CONCLUSION: 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.