Successful treatment of nonhealing biliary-cutaneous fistulas with biliary stents.

Biliary-cutaneous fistulas occasionally complicate biliary tract surgery. Distal biliary obstruction, extensive loss of bile duct wall, or infection may contribute to the failure of such fistulas to heal. Five cases are reported of high-volume persistent fistulas that healed promptly after placement of endoscopic (4 cases) or percutaneous (1 case) biliary stents. Biliary stent placement eliminated the need for difficult reoperations in these complex patients and offers a promising therapeutic approach to this problem.