Biliary Fistula After Pancreaticoduodenectomy

Abstract

Literature searches were carried out on the Pubmed information platform and in the elibrary and Cyberleninka libraries by Keywords. Inclusion criteria are the following: availability of the full-text version of the original article, full compliance with the topic, publication period no more than 5 years. From 144 publications received, those completely duplicated and not meeting the inclusion criteria, were excluded. A total of 36 articles are included in the review. The epidemiology of biliary fistula after pancreatoduodenal resection, modern views on pathogenesis, classification, preventive measures and therapeutic and diagnostic tactics during its development are considered. In the postoperative period of pancreatoduodenal resection, biliary fistula is formed with a frequency of 1-24%. Non-modifiable risk factors include male gender, thin common bile duct, benign biliopancreatoduodenal pathology, and cancer with previous neoadjuvant therapy. Modifiable risk factors include obesity, hypoalbuminemia, obstructive jaundice, duration of hepaticojejunostomy, and prior endoscopic biliary drainage. Nowadays, effective and safe procedures are available in modern interventional radiology for the diagnosis and treatment of postoperative biliary fistula, which can be used as an alternative to endoscopic manipulations and revision interventions when the latter are associated with high risks of complications. Timely detection and treatment ensures the prevention of severe biliary fistula and repeated interventions and favorable prognosis, as well as saving medical and financial resources.