Korean J Pancreas Biliary Tract.  2019 Jan;24(1):35-39. 10.15279/kpba.2019.24.1.35.

Endoscopic Management of Bronchobiliary Fistula after Multiple Transcatheter Arterial Chemoembolizations for Hepatocellular Carcinoma

Affiliations
  • 1Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea. widebrow@empal.com

Abstract

Bronchobiliary fistula (BBF) is a rare complication after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma. We present a case of BBF that developed 5 months after 11 TACE procedures in a 78-year-old male patient with a 3-month history of a persistent cough and yellowish sputum. BBF was found between the bronchus and the right intrahepatic bile duct (B7) by magnetic resonance cholangiopancreatography. On the initial endoscopic retrograde cholangiopancreatography (ERCP), we failed to approach to the BBF due to severe hilar obstruction. Percutaneous transhepatic biliary drainage (PTBD) was performed, and 30-50 mL of bile was drained daily. But the BBF was not resolved until 2 months after PTBD. The patient was treated by placement of a plastic stent to the BBF site during the second ERCP. BBF was resolved 7 days after ERCP on the PTBD tubogram. The patient remained asymptomatic after the stent placement, and there was no recurrence at the 2-month follow-up ERCP.

Keyword

Fistula; Cholangiopancreatography; Endoscopic retrograde; Transcatheter arterial chemoembolization

MeSH Terms

Aged
Bile
Bile Ducts, Intrahepatic
Bronchi
Carcinoma, Hepatocellular*
Cholangiopancreatography, Endoscopic Retrograde
Cholangiopancreatography, Magnetic Resonance
Cough
Drainage
Fistula*
Follow-Up Studies
Humans
Male
Plastics
Recurrence
Sputum
Stents
Plastics
Full Text Links
  • KJPBT
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr