Abstract：
Thoracobiliary fistula (TBF) is a rare condition, in which an atypical communication between the bronchial tree and the biliary tree is present. A comprehensive literature search was conducted on Medline, Embase and Web of Science databases for studies reporting TBF in children. Data regarding patient demographics, site of fistula presentation, preoperative diagnostic procedures needed, and treatment modalities employed were extracted for further analysis. The study pool consisted of 43 studies incorporating 48 cases of TBF. The most frequent symptom was bilioptysis (67%), followed by dyspnea (62.5%), cough (37.5%) and respiratory failure (33%). Regarding the origin of fistula, the left hepatic duct was involved in 29 cases (60.4%), the right hepatic duct in 4 cases (8.3%), and the hepatic junction in 1 case (2%). Surgical management was employed in 46 patients (95.8%). Fistulectomy was performed in 40 patients (86.9%), lung lobectomy or pneumonectomy in 6 (13%), Roux en Y hepaticojejunostomy in 3 (6.5%), and decortication or drainage in 3 cases (6.5%). Three patients died (overall mortality 6.3%), while 17 patients suffered from postoperative complications (overall morbidity 35.4%). TBF in children is a rare but morbid entity which evolves as a result of congenital malformation in the majority of cases. Preoperative imaging of the biliothoracic communication and proper surgical treatment are the components of current management.
摘要：
胸胆瘘（TBF）是一种罕见的疾病，其中支气管树和胆道树之间存在非典型的交流。在Medline上进行了全面的文献检索，Embase和WebofScience数据库，用于报告儿童TBF的研究。有关患者人口统计的数据，瘘管出现部位,需要术前诊断程序，提取所采用的治疗方式进行进一步分析。研究池由43项研究组成，包括48例TBF。最常见的症状是咯血（67%），其次是呼吸困难（62.5%），咳嗽（37.5%）和呼吸衰竭（33%）。关于瘘管的起源，左肝导管累及29例(60.4%),右肝导管4例(8.3%),肝交界处1例(2%)。46例(95.8%)采用手术治疗。40例（86.9%）患者行瘘管切除术，肺叶切除或全肺切除6例（13%），RouxenY肝空肠吻合术3例（6.5%），剥皮或引流3例(6.5%)。3例患者死亡（总死亡率为6.3％），17例患者有术后并发症(总发病率为35.4%)。儿童TBF是一种罕见但病态的实体，在大多数情况下是由于先天性畸形而演变的。术前胆道成像和适当的手术治疗是当前管理的组成部分。
