On the basis of 4 cases (three bilio-bronchial fistulae of hydatic origin, and one post-traumatic fistula), the authors review the problems of etiology and of pathological physiology. After an interpretation of the results obtained they recommend the bi-polar approach (pulmonary and biliary) in the same surgical intervention. In relation with the condition of the patient the second stage of the intervention will be performed after 14 to 21 days (the abdominal stage being carried out after the thoracic stage).
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