Rumyantsev K. Diagnostics and treatment of spontaneous internal biliar fistulas

The developments of gallbladder disease on a background of spontaneous internal bile fistulas are analyzed, grounded on the generalizing of results of treatment in 96 patients with spontaneous internal bile fistulas. The data of instrumental examination methods for the first time are described, which one can be considered as pathognomonic signs: the "microcyst" - gallbladder less than 3 cm in the greatest size; the gas in the bile ducts; a part of an alimentary "tube" contrasting through a fistulous course. It is established, that the basic technical moments during an operation are: laparotomic access, cholecystectomia in "from the bottom" technique, sounding of the choledochus, fulfilment of plastic operations on extrahepatic bile paths at their drawing in a fistula, careful examination of all intestinal "tube" for exposing of possible bile concrements in its gap, recovery of integrity of an intestinal tube by sewing up of the fistulous defect of hollow organ or its resection with imposing of an anastomosis.