Background: Biliopleural fistula is a rare communication between the biliary system and the pleural space secondary to ruptured hydatid cysts, hepatobiliary surgeries or penetrating wounds. There is not so much of the subject in the literature, so there is no standardized protocol for its management. Objective: The objective of this work is to determine advantages and disadvantages of the use of ERCP as a conservative initial treatment for biliopleural fistulas. Method: Our retrospective study included patients with a diagnosis of biliopleural fistula who underwent ERCP as initial treatment, older than 18 years in a period from August 2016 to August 2019. Results: Eight patients with a diagnosis of biliopleural fistula were included, 75% men and 25% women with a mean age of 24.5 years; the traumatic etiology was predominant in our group (89%), the diagnosis was made between days 3 and 14 after chest tube placement and we were successful in treating the fistula with ERCP in 87.5% of our patients. Conclusions: The use of ERCP as initial treatment for biliopleural fistula should be considered as the initial tool in the algorithm of management of this entity.

Background: Biliopleural fistula is a rare communication between the biliary system and the pleural space secondary to ruptured hydatid cysts, hepatobiliary surgeries or penetrating wounds. There is not so much of the subject in the literature, so there is no standardized protocol for its management. Objective: The objective of this work is to determine advantages and disadvantages of the use of ERCP as a conservative initial treatment for biliopleural fistulas. Method: Our retrospective study included patients with a diagnosis of biliopleural fistula who underwent ERCP as initial treatment, older than 18 years in a period from August 2016 to August 2019. Results: Eight patients with a diagnosis of biliopleural fistula were included, 75% men and 25% women with a mean age of 24.5 years; the traumatic etiology was predominant in our group (89%), the diagnosis was made between days 3 and 14 after chest tube placement and we were successful in treating the fistula with ERCP in 87.5% of our patients. Conclusions: The use of ERCP as initial treatment for biliopleural fistula should be considered as the initial tool in the algorithm of management of this entity.

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siendo el sexo masculino el mayormente afectado. Presentamos el caso de un varón de 16 años con pectus excavatum e índice de Haller de 4, a quien se somete a cirugía de pectus up con sistema de tracción esternal externa y fijación con tornillos. Se obtuvo una muy buena respuesta funcional y estética en su posoperatorio. La cirugía de pectus up como método poco invasivo da buenos resultados posoperatorios.

El carcinoma primario en el conducto cístico es un tumor raro y abarca del 0.1% al 0.2% de los carcinomas del tracto gastrointestinal. Presentamos el caso de un varón con pérdida de peso e ictericia, en el que se demuestra por imagen una dilatación de vías intrahepática y extrahepática condicionada por una compresión extrínseca del colédoco. Se realiza colangiografía pancreática retrógrada endoscópica que confirma la compresión, por lo que se lleva a cabo una exploración quirúrgica que evidencia una tumoración del conducto cístico. Se realiza colecistectomía con resección de ganglios linfáticos, además de anastomosis hepatoyeyunal. La tumoración se reporta como carcinoma del conducto cístico sin involucro ganglionar.