Broncho biliary fistula following interventional radiology for hepatic metastases

Abstract

Bronchobiliary fistulas are defined as an abnormal communication between the biliary system and the bronchial tree. They are extremely rare complications of radiofrequency or microwave ablation. A 39-year-old woman with a history of neuroendocrine pancreatic carcinoma suffering from liver metastasis was treated with microwave ablation (MWA). In this case report, we present a case of intractable biliptysis from a bronchobiliary fistula secondary to an MWA. The patient was diagnosed by endoscopic retrograde cholangiopancreatograph and hepatobiliary scintigraphy. Treatment involved a right hemihepatectomy, a redo-hepaticojejunostomy, and the surgical placement of a transhepatic drain. After 6 weeks of drain placement, this could be removed. The fistula was thus successfully treated.

Zusammenfassung

Bronchobiliäre Fisteln bezeichnen pathologische Verbindungen zwischen dem Bronchialbaum und den Gallenwegen. Insgesamt gehören sie zu den sehr seltenen Komplikationen nach Radiofrequenz- oder Mikrowellenablation. Dieser Fallbericht beschreibt eine 39-jährige Patientin mit einem hepatisch metastasierten neuroendokrinen Tumor des Pankreas, welche nach lokal ablativer Therapie per Mikrowellenablation eine broncho-biliäre Fistel entwickelte. Die diagnostische Abklärung bestand aus einer endoskopischen retrograden Cholangiopankreatikografie und einer hepatobiliären Sequenzszintigrafie. Die Therapie erfolgte operativ mit einer Hemihepatectomie rechts und einer Hepaticojejunostomie mit Neuhaus-Drainageneinlage. Sechs Wochen postoperativ konnte die Drainage entfernt werden. Die Fistel war vollständig abgeheilt.

Keywords

biliptysis - bronchobiliary fistula - bronchial fistula - ablation - pancreatic neuroendocrine tumor

Schlüsselwörter

Bilioptyse - bronchobiliäre Fistel - Bronchialfistel - Ablation - neuroendokriner Pankreastumor

Publication History

Received: 31 October 2023

Article published online:
11 April 2024

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