Nonoperative therapy of the posttraumatic biliary fistula in adolescents

Posttraumatic biliary fistula is one of the complications of major hepatic injury. Conventional treatment has consisted of surgical intervention with hepatic debridement, ductal repair, and controlled drainage. The authors pr esent two boys, 15 and 17 years of age, with biliary fistulas resulting aft er major hepatic injury. Biliary fistulas were successfully treated nonoper atively with sphincterotomy and endoscopically inserted small-caliber stent s. The duration of time between stent placement and closure of the fistulas were 2 and 8 days, respectively. 2.5 years after injury, both patients are without problems. These cases demonstrate the effectiveness of nonoperativ e management of traumatic biliary fistulas in adolescents.