Smith's mucosal graft operation in a case of external biliary fistula

ABSTRACT

A patient with external biliary fistula after cholecystectomy was admitted in Surgical Unit-1, Nishtar Hospital, Multan. The patient had fever and jaundice which was obstructive in nature. On exploratory laparotomy, bile was seen coming out of a track lined by fibrous tissue. After a difficult dissection of the track, we ended up with the finding of the openings of right and left hepatic ducts in the porta hepatis. The common hepatic duct and the common bile duct could not be traced. A short distal stump of common bile duct was found after duodenotomy and probing of the ampulla of Vater. An end to end anastomosis of the duct was not possible. A mucosal graft operation was performed. The problems of management of this complication are discussed