@article{3339729,
    title = "The management of thoracobiliary fistulas in children: a systematic review",
    author = "Koliakos, N. and Papaconstantinou, D. and Tzortzis, A.-S. and Kykalos, S. and Bakopoulos, A. and Zavras, N. and Schizas, D.",
    journal = "Pediatric Surgery International",
    year = "2023",
    volume = "39",
    number = "1",
    publisher = "Springer Science and Business Media Deutschland GmbH",
    issn = "0179-0358, 1437-9813",
    doi = "10.1007/s00383-023-05431-z",
    keywords = "abdominal abscess;  abdominal pain;  airway obstruction;  bile duct fistula;  bile leakage;  bronchography;  child;  childhood disease;  cholestasis;  coughing;  demographics;  dysphagia;  dyspnea;  Embase;  endoscopic retrograde cholangiopancreatography;  hepatojejunostomy;  human;  jaundice;  lung lobectomy;  magnetic resonance cholangiopancreatography;  Medline;  meta analysis;  peroperative cholangiography;  pneumonectomy;  pneumonia;  pneumothorax;  postoperative complication;  postoperative hemorrhage;  preoperative period;  respiratory failure;  Review;  surgical infection;  systematic review;  thoracobiliary fistula;  thoracoscopy;  thoracotomy;  thorax pain;  Web of Science;  adverse event;  bile duct fistula;  biliary tract surgery;  common hepatic duct;  liver, Biliary Fistula;  Biliary Tract Surgical Procedures;  Child;  Drainage;  Hepatic Duct, Common;  Humans;  Liver",
    abstract = "Thoracobiliary fistula (TBF) is a rare condition, in which an atypical communication between the bronchial tree and the biliary tree is present. A comprehensive literature search was conducted on Medline, Embase and Web of Science databases for studies reporting TBF in children. Data regarding patient demographics, site of fistula presentation, preoperative diagnostic procedures needed, and treatment modalities employed were extracted for further analysis. The study pool consisted of 43 studies incorporating 48 cases of TBF. The most frequent symptom was bilioptysis (67%), followed by dyspnea (62.5%), cough (37.5%) and respiratory failure (33%). Regarding the origin of fistula, the left hepatic duct was involved in 29 cases (60.4%), the right hepatic duct in 4 cases (8.3%), and the hepatic junction in 1 case (2%). Surgical management was employed in 46 patients (95.8%). Fistulectomy was performed in 40 patients (86.9%), lung lobectomy or pneumonectomy in 6 (13%), Roux en Y hepaticojejunostomy in 3 (6.5%), and decortication or drainage in 3 cases (6.5%). Three patients died (overall mortality 6.3%), while 17 patients suffered from postoperative complications (overall morbidity 35.4%). TBF in children is a rare but morbid entity which evolves as a result of congenital malformation in the majority of cases. Preoperative imaging of the biliothoracic communication and proper surgical treatment are the components of current management. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature."
}