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Choledochoduodenal fistula in Mainland China: a review of epidemiology, etiology, diagnosis and management

PURPOSE: Choledochoduodenal fistula (CDF) is an extremely rare condition even in the most populous nations. However, diagnostic tools are inadequate for the young surgeon to be made aware of such a rare condition before surgery. Hence, basic understanding of the epidemiology, etiology, and managemen...

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Autores principales: Wu, Ming-Bing, Zhang, Wen-Feng, Zhang, Ying-Lin, Mu, Di, Gong, Jian-Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Surgical Society 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4644904/
https://www.ncbi.nlm.nih.gov/pubmed/26576403
http://dx.doi.org/10.4174/astr.2015.89.5.240
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author Wu, Ming-Bing
Zhang, Wen-Feng
Zhang, Ying-Lin
Mu, Di
Gong, Jian-Ping
author_facet Wu, Ming-Bing
Zhang, Wen-Feng
Zhang, Ying-Lin
Mu, Di
Gong, Jian-Ping
author_sort Wu, Ming-Bing
collection PubMed
description PURPOSE: Choledochoduodenal fistula (CDF) is an extremely rare condition even in the most populous nations. However, diagnostic tools are inadequate for the young surgeon to be made aware of such a rare condition before surgery. Hence, basic understanding of the epidemiology, etiology, and management for this unusual but discoverable condition are necessary and essential. METHODS: The exclusive case reports of CDF, which were published from 1983 to 2014 concerning mainland Chinese people, were performed to review the epidemiology, etiology, and management. RESULTS: A total of 728 cases were incorporated into this review among 48 papers. More than half of the CDF cases were female (416) with an average age of 57.3 years. CDF was usually caused by cholelithiasis (573 of 728). Epigastric pain (589 of 728) and cholangitis (395 of 728) were the most common symptoms of CDF. CDF was usually detected and confirmed by endoscopic retrograde cholangiopancreatography (ERCP) (475 of 728) in Mainland China. The fistulas larger than 1 cm (82 of 654) were recommended for surgical biliary reconstruction. Fistulas between 0.5 cm and 1.0 cm (467 of 654) which were followed frequently by cholangitis attacks also required surgery; the rest were recommended to have stone removal and/or the application of an effective biliary drainage. Fistulas less than 0.5 cm (105 of 654) were usually received conservative therapy. CONCLUSION: CDF should be considered in differential diagnosis of recurrent epigastric pain and cholangitis. A possible ERCP should be arranged to investigate carefully. Depending on the size of fistula and clinical presentation, different programs for CDF are indicated, ranging from drug therapy to choledochojejunostomy.
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spelling pubmed-46449042015-11-16 Choledochoduodenal fistula in Mainland China: a review of epidemiology, etiology, diagnosis and management Wu, Ming-Bing Zhang, Wen-Feng Zhang, Ying-Lin Mu, Di Gong, Jian-Ping Ann Surg Treat Res Original Article PURPOSE: Choledochoduodenal fistula (CDF) is an extremely rare condition even in the most populous nations. However, diagnostic tools are inadequate for the young surgeon to be made aware of such a rare condition before surgery. Hence, basic understanding of the epidemiology, etiology, and management for this unusual but discoverable condition are necessary and essential. METHODS: The exclusive case reports of CDF, which were published from 1983 to 2014 concerning mainland Chinese people, were performed to review the epidemiology, etiology, and management. RESULTS: A total of 728 cases were incorporated into this review among 48 papers. More than half of the CDF cases were female (416) with an average age of 57.3 years. CDF was usually caused by cholelithiasis (573 of 728). Epigastric pain (589 of 728) and cholangitis (395 of 728) were the most common symptoms of CDF. CDF was usually detected and confirmed by endoscopic retrograde cholangiopancreatography (ERCP) (475 of 728) in Mainland China. The fistulas larger than 1 cm (82 of 654) were recommended for surgical biliary reconstruction. Fistulas between 0.5 cm and 1.0 cm (467 of 654) which were followed frequently by cholangitis attacks also required surgery; the rest were recommended to have stone removal and/or the application of an effective biliary drainage. Fistulas less than 0.5 cm (105 of 654) were usually received conservative therapy. CONCLUSION: CDF should be considered in differential diagnosis of recurrent epigastric pain and cholangitis. A possible ERCP should be arranged to investigate carefully. Depending on the size of fistula and clinical presentation, different programs for CDF are indicated, ranging from drug therapy to choledochojejunostomy. The Korean Surgical Society 2015-11 2015-10-28 /pmc/articles/PMC4644904/ /pubmed/26576403 http://dx.doi.org/10.4174/astr.2015.89.5.240 Text en Copyright © 2015, the Korean Surgical Society http://creativecommons.org/licenses/by-nc/4.0/ Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Wu, Ming-Bing
Zhang, Wen-Feng
Zhang, Ying-Lin
Mu, Di
Gong, Jian-Ping
Choledochoduodenal fistula in Mainland China: a review of epidemiology, etiology, diagnosis and management
title Choledochoduodenal fistula in Mainland China: a review of epidemiology, etiology, diagnosis and management
title_full Choledochoduodenal fistula in Mainland China: a review of epidemiology, etiology, diagnosis and management
title_fullStr Choledochoduodenal fistula in Mainland China: a review of epidemiology, etiology, diagnosis and management
title_full_unstemmed Choledochoduodenal fistula in Mainland China: a review of epidemiology, etiology, diagnosis and management
title_short Choledochoduodenal fistula in Mainland China: a review of epidemiology, etiology, diagnosis and management
title_sort choledochoduodenal fistula in mainland china: a review of epidemiology, etiology, diagnosis and management
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4644904/
https://www.ncbi.nlm.nih.gov/pubmed/26576403
http://dx.doi.org/10.4174/astr.2015.89.5.240
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