Endoscopic Management of Bronchobiliary Fistula after Multiple Transcatheter Arterial Chemoembolizations for Hepatocellular Carcinoma
10.15279/kpba.2019.24.1.35
- Author:
Jin YU
1
;
Tae Yoon LEE
;
Young Koog CHEON
;
Chan Sup SHIM
Author Information
1. Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea. widebrow@empal.com
- Publication Type:Case Report
- Keywords:
Fistula;
Cholangiopancreatography;
Endoscopic retrograde;
Transcatheter arterial chemoembolization
- MeSH:
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
- From:Korean Journal of Pancreas and Biliary Tract
2019;24(1):35-39
- CountryRepublic of Korea
- Language:Korean
-
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.
