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AMA Arch Surg. 1953;66(2):260-264. doi:10.1001/archsurg.1953.01260030273018.
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INTERNAL biliary fistulas, although not common, are no longer surgical curiosities. Choledochoduodenal fistulas, other than those secondary to cholelithiasis, are, however, extremely rare. Judd and Burden,1 in their review of 153 cases of internal biliary fistula at the Mayo Clinic in which surgery had been performed, found only 1 such fistula between the common duct and the duodenum, while they encountered 148 between the gall bladder and the duodenum. They felt that all of these fistulas had been caused by cholelithiasis. Davison and Aries2 found only 7 cases of internal biliary fistula in 6,000 autopsies at Cook County Hospital, and in none of these was an antemortem diagnosis made. Bernard,3 according to Eliason and Stevens,4 found 109 such fistulas in 6,263 patients having surgical intervention upon the biliary system, an incidence of 1.8% in biliary tract surgery. Those authors describe the following types of biliary fistulas:


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