Boyd D P
Ann Thorac Surg. 1977 Nov;24(5):481-7. doi: 10.1016/s0003-4975(10)63443-1.
In the course of treating approximately 2,000 patients with postoperative stricture of the bile duct, 16 bronchopleural and bronchobiliary fistulas were encountered. Three patients have been seen in the past year. This has prompted a review of our experience since it was previously recorded in 1955. Fistulous complications of obstructive biliary tract disease take three forms: (1) massive fulminating biliary empyema; (2) acute necrotizing bile bronchiolitis and pneumonia when pleural symphysis exists; and (3) a more indolent, chronic, recurring form of bronchobiliary communication. We have learned that transdiaphragmatic perforation occurs at a certain characteristic location in the diaphragm. An understanding of the pathological anatomy and pathogenesis has provided a specific and sequential mode of surgical treatment. When this has been adhered to strictly, cure has resulted.
在治疗约2000例术后胆管狭窄患者的过程中，出现了16例支气管胸膜瘘和支气管胆管瘘。过去一年里有3例患者前来就诊。这促使我们回顾自1955年首次记录以来的经验。梗阻性胆道疾病的瘘管并发症有三种形式：（1）大量暴发性胆源性脓胸；（2）存在胸膜粘连时的急性坏死性细支气管炎和肺炎；（3）一种较为隐匿、慢性、反复发作的支气管胆管相通形式。我们了解到经膈穿孔发生在膈肌的某个特定特征部位。对病理解剖和发病机制的认识提供了一种具体且连贯的手术治疗方式。严格遵循这一方式，即可实现治愈。
