ENDOSCOPIC TREATMENT FOR BILIARY FISTULA 69 FIGURE ERCP: contrast material leakage in the biliary branch of the VIIIth segment. performed by Burmeister et al. [18] in 1985, with a nasobiliary drainage tube. The first use of endopros- theses in external biliary fistulas was described in 1986 by Huibregtse et al. [19] and by Smith et al. [11] and, subsequently by Devier et al. [20] in 1987. ERCP permits a complete study of the biliary tree, except for fistulas caused by complete ligature of choledochus: however, patients with these fistulas are candidates for surgery. In all other patients bilio- cutaneous fistulas, an 86% success rate is reported [3,6]. Some authors [3] suggest inserting an endoprosthe- sis instead of the nasobiliary tube because of physio- logic duodenal bile drainage. Other authors 14] report a 100% success rate with use of sphincterotomy asso- ciated with a nasobiliary tube.