Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (675 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Abnormal passage in any organ of the biliary tract or between biliary organs and other organs.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Biliary Fistulas; Fistula, Biliary; Fistulas, Biliary.
Where it fits in the MeSH classification
- Broader topics
- Digestive System Fistula
Research landscape
PubMed indexes 4,048 records tagged with the MeSH heading “Biliary Fistula” (counts retrieved 2026-11-04). 206 of them (5.1%) were published from 2020 onward, and the busiest period so far is through 1999 with 2,828 records.
Reviews account for 190 records (4.7%) and meta-analyses for 4. Randomized controlled trials number 8 (0.2%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 2,828 |
| 2000-2009 | 533 |
| 2010-2019 | 481 |
| 2020 onward | 206 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 190 | 4.7% |
| Meta-analyses | 4 | 0.1% |
| Randomized controlled trials | 8 | 0.2% |
Method: PubMed query "Biliary Fistula"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in digestive system and liver
Gut and liver research ranges from laboratory studies of the microbiome to large trials of drugs and surgery. Symptoms such as pain, reflux or bowel change are reported by patients and overlap between conditions, and diet and microbiome studies are mostly observational. Check whether the study measured symptoms, tissue findings or long-term outcomes, how the diagnosis was made and how long people were followed. Nothing here replaces advice from a qualified clinician.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Risk Factors and Managements of Bile Leakage After Hepatectomy | 2016 | Research article Design not recorded in structured metadata | 61 | cc by PMID 26159119 · DOI · PMC4695499 |
| The internal biliary fistula--reappraisal of incidence, type, diagnosis and management of 33 consecutive cases | 1997 | Research article Design not recorded in structured metadata | 57 | cc by PMID 9174858 · DOI · PMC2423849 |
| Management of acquired bronchobiliary fistula: 3 case reports and a literature review | 2007 | Review article Design not recorded in structured metadata | 52 | cc by PMID 18053192 · DOI · PMC2217537 |
| Cholecysto-duodenal and cholecysto-colic fistulae identified intraoperatively during laparoscopic cholecystectomy in a surgical hub | 2026 | Research article Design not recorded in structured metadata | 1 | cc by PMID 40663000 · DOI · PMC13318454 |
Risk Factors and Managements of Bile Leakage After Hepatectomy [1]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundThe purpose of this study was to retrospectively determine the risk factors and evaluate the management of bile leakage.
- Closing excerpt
- Central type of bile leakage is sometimes refractory to therapy, needing various treatments and requiring a long time for recovery.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (259 words)
BackgroundThe purpose of this study was to retrospectively determine the risk factors and evaluate the management of bile leakage.MethodsThree hundred and thirty-four patients who underwent hepatectomy for Child classification grade A liver disease, without biliary reconstruction and laparoscopic procedures, between 2003 and 2013 were included. Risk factors were identified using multivariate analysis.ResultsBile leakage was observed in 30 (9.0%) patients. Multivariate analysis demonstrated that type of hepatectomy (segmentectomy 1, medial sectionectomy, anterior sectionectomy, or central bisectionectomy) and operating time was independent risk factors for bile leakage. Among 30 patients with confirmed bile leakage, central type leakage that was in communication with the biliary tree occurred in 23 (76.7%) patients and peripheral type, which was not in communication with the biliary tree, in 7 (23.3%) patients. Ten patients were treated with only drainage. Endoscopic or percutaneous transhepatic procedures were performed in 15 cases with central type leakage. Ablation treatment using ethanol or minocycline was mainly performed for peripheral type leakage. Four cases with central type leakage had strictures of the right hepatic duct. Two of them were treated with ablation treatment, portal vein embolization, or fistulojejunostomy. Median duration from diagnosis to end of therapy was 77 days (11-323) in central type and 44 days (6-123) in peripheral type leakage, respectively.ConclusionsComplex hepatectomy and operating time are independent risk factors for postoperative bile leakage. Biliary exploration should be performed as soon as possible after diagnosis, because most bile leakage is the central type. Central type of bile leakage is sometimes refractory to therapy, needing various treatments and requiring a long time for recovery.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 26159119 · DOI · PMC4695499
The internal biliary fistula--reappraisal of incidence, type, diagnosis and management of 33 consecutive cases [2]
Abstract reading summary — source excerpts
- Opening excerpt
- To reevaluate the current features of spontaneous internal biliary fistulas, we reviewed 1,929 consecutive patients who had been treated for biliary tract diseases during the recent 12-year period.
- Closing excerpt
- Since the preoperative diagnostic rate for internal biliary fistula involving the gallbladder is still low, care is necessary before and at the time of surgery especially during laparoscopic cholecystectomy for elderly patients with cholelithiasis.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (224 words)
To reevaluate the current features of spontaneous internal biliary fistulas, we reviewed 1,929 consecutive patients who had been treated for biliary tract diseases during the recent 12-year period. Thirty-three patients had internal biliary fistulas and the incidence was 1.9%. Of 33 patients, 20 were women and 13 were men with the average age 63 years, and their mean duration of illness was 4 years. A total of 37 fistulas were found and the most common type was choledochoduodenal (62%), followed by cholecystoduodenal (19%), cholecystocholedochal (11%) and cholecystocolonic (8%) fistulas. Internal biliary fistulas of thirty-one patients were caused by biliary stones and those of two patients by malignant tumors. All of the 17 bile samples examined were bacteria positive and the majority of calculi were brown pigment stones. All of the choledochoduodenal fistulas were correctly diagnosed by endoscopic retrograde cholangiography. In 14 patients with cholecystoenteric or cholecystocholedochal fistulas, direct evidence of the internal fistula was obtained only in 7 patients (50%) preoperatively. Pneumobilia, a small atrophic gallbladder adherent to the neighboring organs and a history of spontaneous disappearance of jaundice in elderly patients may indicate the presence of a cholecystoentric fistula. Since the preoperative diagnostic rate for internal biliary fistula involving the gallbladder is still low, care is necessary before and at the time of surgery especially during laparoscopic cholecystectomy for elderly patients with cholelithiasis.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 9174858 · DOI · PMC2423849
Management of acquired bronchobiliary fistula: 3 case reports and a literature review [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Bronchobiliary fistula (BBF), which often presents with bilioptysis, is an abnormal communication between the bronchial system and biliary tree.
- Closing excerpt
- This paper presents 3 cases of BBF and reviews the literature regarding the treatment options generally mandated by clinical presentation and the underlying disease.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (85 words)
Bronchobiliary fistula (BBF), which often presents with bilioptysis, is an abnormal communication between the bronchial system and biliary tree. It is a complication associated with a high mortality rate and requires a well-planned management strategy. Although hydatid disease is still the leading cause, extensive surgical interventions and invasive procedures of the liver have altered the profile of patients in recent decades. This paper presents 3 cases of BBF and reviews the literature regarding the treatment options generally mandated by clinical presentation and the underlying disease.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 18053192 · DOI · PMC2217537
Cholecysto-duodenal and cholecysto-colic fistulae identified intraoperatively during laparoscopic cholecystectomy in a surgical hub [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstone disease and is often performed in elective settings.
- Closing excerpt
- This rare intraoperative finding, in a low-risk, preoperatively uncomplicated case highlights the importance of surgical vigilance and reinforces the need for surgical hubs to be equipped with appropriate expertise, instruments, and escalation pathways to manage unanticipated intraoperative complexity.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (107 words)
Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstone disease and is often performed in elective settings. To address surgical backlogs, the United Kingdom has adopted off-site elective surgical hubs designed for high-volume, low-complexity procedures. We describe a case of a young woman undergoing laparoscopic cholecystectomy at a surgical hub, in whom two cholecysto-enteric fistulae - cholecysto-duodenal and cholecysto-colic - were unexpectedly identified intraoperatively. Both were successfully managed laparoscopically. This rare intraoperative finding, in a low-risk, preoperatively uncomplicated case highlights the importance of surgical vigilance and reinforces the need for surgical hubs to be equipped with appropriate expertise, instruments, and escalation pathways to manage unanticipated intraoperative complexity.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40663000 · DOI · PMC13318454
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus [5]
- Research article Management of acquired bronchobiliary fistula: A systematic literature review of 68 cases published in 30 years [6]
- Research article Cholecystocolonic fistula: facts and myths. A review of the 231 published cases [7]
- Research article Management of gallstones and its related complications [8]
- Research article [Classification and treatment of bile duct injuries after laparoscopic cholecystectomy] [9]
- Research article Cysto-biliary communication in liver hydatidosis [10]
References
- Sakamoto K, Tamesa T, Yukio T, Tokuhisa Y, Maeda Y, Oka M. Risk Factors and Managements of Bile Leakage After Hepatectomy. . 2016. PMID 26159119 · DOI · PMC4695499
- Yamashita H, Chijiiwa K, Ogawa Y, Kuroki S, Tanaka M. The internal biliary fistula--reappraisal of incidence, type, diagnosis and management of 33 consecutive cases. . 1997. PMID 9174858 · DOI · PMC2423849
- Eryigit H, Oztas S, Urek S, Olgac G, Kurutepe M, Kutlu CA. Management of acquired bronchobiliary fistula: 3 case reports and a literature review. . 2007. PMID 18053192 · DOI · PMC2217537
- Smith CR, Valnarov-Boulter A, Kerwat R. Cholecysto-duodenal and cholecysto-colic fistulae identified intraoperatively during laparoscopic cholecystectomy in a surgical hub. . 2026. PMID 40663000 · DOI · PMC13318454
- Abou-Saif A, Al-Kawas FH. Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Am J Gastroenterol. 2002. PMID 11866258 · DOI
- Liao GQ, Wang H, Zhu GY, Zhu KB, Lv FX, Tai S. Management of acquired bronchobiliary fistula: A systematic literature review of 68 cases published in 30 years. World J Gastroenterol. 2011. PMID 21987628 · DOI · PMC3181447
- Costi R, Randone B, Violi V, Scatton O, Sarli L, Soubrane O, et al.. Cholecystocolonic fistula: facts and myths. A review of the 231 published cases. J Hepatobiliary Pancreat Surg. 2009. PMID 19089311 · DOI
- Portincasa P, Di Ciaula A, de Bari O, Garruti G, Palmieri VO, Wang DQ. Management of gallstones and its related complications. Expert Rev Gastroenterol Hepatol. 2016. PMID 26560258 · DOI
- Neuhaus P, Schmidt SC, Hintze RE, Adler A, Veltzke W, Raakow R, et al.. [Classification and treatment of bile duct injuries after laparoscopic cholecystectomy]. Chirurg. 2000. PMID 10734585 · DOI
- Ramia JM, Figueras J, De la Plaza R, García-Parreño J. Cysto-biliary communication in liver hydatidosis. Langenbecks Arch Surg. 2012. PMID 22374106 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
See how EvidenceLib is built. Spotted an error? Email support@evidencehelix.com.
Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.