Statistic analysis
Keywords:
statistical, billiodigestive fistula, digestive surgeryAbstract
A hundred· and twelve cases of biliodigestive fistulas treated at the University Hospital of the College of Medicine (Hospital de Clínicas) of Montevideo, during
a nineteen-year period are analyzed ( 1953-1972). Biliobiliary fistulas are included. One fistula was found per every 50 operations for biliary lithiasis, since the. ethiology of the latter is
the most frequent. Duodenal ulcers accounted only for 1.7 % of fistulas. Biliodigestive fistulas are more frequent in women than in men and the majority of patients had biliary history for over 12 years. Almost half of the cases were hospitalized due to a complication of the fistula; more than a quarter had jaundice at one time or another, over a quarter suffere'd
from diabetes and many of them were overweight. There were 26 gallstone ileus (23,2 % ) , 14 cholangitis ( 12,5 % ) , 4 digestive hemorrhages (3.5 % ) and 5 gastroduodenal
stenosis ( 4,4 % ) . Diagnosis was confirmed in 109 cases during surgery and 3 in post-mortem examinations. In 8 cases ( 7 .1 % ) the fistula was associated to gall
bladder cancer. Cholecystoduodenal fistulas accounted for 73 cases ( 65 % ) , cholecystocolic fistulas for 12 (10.7 % ) and cholecystogastric fistulas 5 ( 4.4 % ) . The treatment consisted in duodenal closure and cholecystectomy in the majority of cases. In gallstone ileus cases, enterotomy and ·removal of gallstones was performed. In the latter, operatory morbility was 30 %
and death rate 11 % .
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