Objective:To analyze the characteristics, diagnosis, and treatment of pulmonary infections related to bronchobiliary fistula (BBF), and to enhance the understanding of this disease.Methods:A total of 33 patients with pulmonary infections related to BBF hospitalized at the Third Affiliated Hospital of Naval Medical University from January 2011 to January 2024 were included in this study. The clinical retrospective case series research method was used to collect and analyze the clinical data of the included patients, including age, clinical manifestations, laboratory tests, imaging studies, bronchoscopy, cholangiography, and treatment.Results:The age of the 33 patients was (51.4±7.9) years. The most common symptoms were coughing and biliary sputum (33/33, 100.0%), followed by fever (23/33, 69.7%). Other common symptoms included chest tightness, dyspnea, chest pain and hemoptysis. Bilirubin tests on sputum were performed in seven cases and on pleural effusions in four cases, and all were positive. Imaging studies revealed pneumonia in all patients, which was adjacent to the diaphragm. All patients had pleural effusion, with additional common findings included subphrenic effusion, liver abscesses, bile duct dilation, and gas in the bile duct. Bronchoscopy was performed on six patients, all of whom exhibited golden yellow biliary secretions. The presence of BBF was confirmed through percutaneous transhepatic cholangiography (6/10), T-tube cholangiography (3/6), and endoscopic retrograde cholangiopancreatography (5/18) in some patients. All patients received anti-infective therapy and supportive treatment. Among the 33 patients, 18(54.5%) cases underwent endoscopic nasobiliary drainage, 12(36.4%) percutaneous transhepatic biliary drainage, 19(57.6%) thoracentesis, 17(51.5%) subphrenic effusion drainage, five (15.2%) liver abscess drainage, 13(39.4%) abdominal paracentesis, and six (18.2%) brochosopic embolization of bronchial fistula. Only three patients underwent surgical intervention when non-surgical treatments failed.Conclusions:The clinical manifestations of pulmonary infections related to BBF are complex. When patients with hepatobiliary diseases present with coughing and biliary sputum, BBF should be highly suspected. Early diagnosis can be achieved through bilirubin testing of sputum or pleural effusion. The main treatments are biliary drainage or percutaneous puncture drainage and other non-surgical treatments. Surgical treatment could be considered only after the failure of non-surgical treatments.

Objective:To analyze the characteristics, diagnosis, and treatment of pulmonary infections related to bronchobiliary fistula (BBF), and to enhance the understanding of this disease.Methods:A total of 33 patients with pulmonary infections related to BBF hospitalized at the Third Affiliated Hospital of Naval Medical University from January 2011 to January 2024 were included in this study. The clinical retrospective case series research method was used to collect and analyze the clinical data of the included patients, including age, clinical manifestations, laboratory tests, imaging studies, bronchoscopy, cholangiography, and treatment.Results:The age of the 33 patients was (51.4±7.9) years. The most common symptoms were coughing and biliary sputum (33/33, 100.0%), followed by fever (23/33, 69.7%). Other common symptoms included chest tightness, dyspnea, chest pain and hemoptysis. Bilirubin tests on sputum were performed in seven cases and on pleural effusions in four cases, and all were positive. Imaging studies revealed pneumonia in all patients, which was adjacent to the diaphragm. All patients had pleural effusion, with additional common findings included subphrenic effusion, liver abscesses, bile duct dilation, and gas in the bile duct. Bronchoscopy was performed on six patients, all of whom exhibited golden yellow biliary secretions. The presence of BBF was confirmed through percutaneous transhepatic cholangiography (6/10), T-tube cholangiography (3/6), and endoscopic retrograde cholangiopancreatography (5/18) in some patients. All patients received anti-infective therapy and supportive treatment. Among the 33 patients, 18(54.5%) cases underwent endoscopic nasobiliary drainage, 12(36.4%) percutaneous transhepatic biliary drainage, 19(57.6%) thoracentesis, 17(51.5%) subphrenic effusion drainage, five (15.2%) liver abscess drainage, 13(39.4%) abdominal paracentesis, and six (18.2%) brochosopic embolization of bronchial fistula. Only three patients underwent surgical intervention when non-surgical treatments failed.Conclusions:The clinical manifestations of pulmonary infections related to BBF are complex. When patients with hepatobiliary diseases present with coughing and biliary sputum, BBF should be highly suspected. Early diagnosis can be achieved through bilirubin testing of sputum or pleural effusion. The main treatments are biliary drainage or percutaneous puncture drainage and other non-surgical treatments. Surgical treatment could be considered only after the failure of non-surgical treatments.

Objective To determine the feasibility and toxicity of the addition of cetuximab to paclitaxel,cisplatin,and concurrent intensity modulated radiation therapy (IMRT) for patients with esophageal squamous cell carcinoma (ESCC).Methods Nineteen patients with stage Ⅰ to Ⅲ ESCC,without distant organ metastases,were eligible.All patients received cetuximab,an initial dose of 400 mg/m2 in the first week followed by weekly injection of 250 mg/m2,paclitaxel 45 mg/m2 and cisplatin 20 mg/m2 weekly for 7 weeks with IMRT of 59.4 Gy/33 fractions.Results Two patients discontinued because of severe adverse events.Seventeen patients completed the planned treatment protocol.Of whom,12 patients achieved completeremission.The objective response rate was 100％.A median follow-up time was 29.3 months.The 1-year overall survival and recurrence-free survival rate was 100％ and 82％,respectively.Main toxicities including myelosuppression,esophagitis and skin rash happened in 19 patients.Grade ≥2 neutropenia,esophagitis and skin toxicity noted rates was 89％,84％ and 58％,respectively.Local recurrence was found in two patients.Neck lymph node and lung metastasis found in one patient.Conclusions Cetuximab,when combined with paclitaxel,cisplatin and IMRT,is efficient and safe for esophageal squamous cell carcinoma,Further clinical study is needed.