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Freidkin L, Azem K, Pertzov B, Izhakian S, Rosengarten D, Kramer MR. Endobronchial closure of broncho-biliary fistula using Amplatzer device: Case report. Respir Med Case Rep 2023; 46:101943. [PMID: 38025252 PMCID: PMC10661852 DOI: 10.1016/j.rmcr.2023.101943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Broncho-biliary fistula (BBF) is an extremely rare but serious medical condition resulting from pathological communication between the biliary system and the bronchial tree. Treatment options include both surgical and non-surgical approaches. Several endobronchial techniques, such as the spigot and glue, can be used for this purpose. This report discusses a patient who developed a broncho-biliary fistula following a liver biopsy. The BBF was diagnosed during bronchoscopy and successfully treated with an endobronchial Amplatzer device. To the best of our knowledge, this is the first report of the use of the Amplatzer device to manage BBF.
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Affiliation(s)
- Lev Freidkin
- Pulmonary Division, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Karam Azem
- Anesthesiology Department, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Barak Pertzov
- Pulmonary Division, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shimon Izhakian
- Pulmonary Division, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dror Rosengarten
- Pulmonary Division, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mordechai R. Kramer
- Pulmonary Division, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Bronchobiliary Fistula Management With Bronchoscopic Occlusive Stenting and Fibrin Glue Instillation. J Bronchology Interv Pulmonol 2022; 29:e49-e51. [PMID: 35730787 DOI: 10.1097/lbr.0000000000000812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3
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Bing Z, Chen R, Xing P, Ren Y, Hou K. Congenital Bronchobiliary Fistula: A Case Report and Literature Review. Front Pediatr 2021; 9:686827. [PMID: 34422718 PMCID: PMC8371316 DOI: 10.3389/fped.2021.686827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/30/2021] [Indexed: 11/13/2022] Open
Abstract
Congenital bronchobiliary fistula (CBBF) is a rare disease. Children with CBBF mostly have atypical clinical manifestations that can be easily missed. We report a case of a child with CBBF who was diagnosed with fistulography with the help of an endobronchial blocker and a fiberoptic bronchoscope. The CBBF was successfully removed by thoracoscopic surgery.
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Affiliation(s)
- Zhen Bing
- Heart Center, Qingdao Women and Children's Hospital, Qingdao, China
| | - Rui Chen
- Heart Center, Qingdao Women and Children's Hospital, Qingdao, China
| | - Pengchao Xing
- Heart Center, Qingdao Women and Children's Hospital, Qingdao, China
| | - Yueyi Ren
- Heart Center, Qingdao Women and Children's Hospital, Qingdao, China
| | - Kefeng Hou
- Heart Center, Qingdao Women and Children's Hospital, Qingdao, China
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Joh HK, Park SY. Surgical Treatment of Bronchobiliary Fistula with Pulmonary Resection and Omentopexy. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2020; 53:38-40. [PMID: 32090057 PMCID: PMC7006612 DOI: 10.5090/kjtcs.2020.53.1.38] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/21/2019] [Accepted: 09/23/2019] [Indexed: 11/17/2022]
Abstract
Bronchobiliary fistula is a rare disease defined as an abnormal connection between the biliary tract and the bronchial tree. We report the successful surgical repair of bronchobiliary fistula. A 78-year-old man underwent surgery and several rounds of transcatheter arterial chemoembolization and radiofrequency ablation as treatment for hepatocellular carcinoma. He presented with greenish sputum and chronic cough for several months, and his symptoms did not resolve after endoscopic treatment. We performed lobectomy of the right lower lobe and omentopexy for bronchobiliary fistula under laparotomy and thoracotomy. The bronchobiliary fistula was successfully closed, and the bilious sputum disappeared after surgery.
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Affiliation(s)
- Hyon Keun Joh
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Yong Park
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea
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Kim HB, Na YS, Lee HJ, Park SG. Bronchobiliary fistula after ramucirumab treatment for advanced gastric cancer: A case report. World J Clin Cases 2019; 7:3039-3046. [PMID: 31624752 PMCID: PMC6795721 DOI: 10.12998/wjcc.v7.i19.3039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/07/2019] [Accepted: 09/12/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Bronchobiliary fistula (BBF) is a rare disease characterized by an abnormal connection between the biliary system and bronchi. Traditional causes of BBF include trauma and infections, and more recent causes include malignancies and certain cancer treatments. Ramucirumab is an antivascular endothelial growth factor receptor 2 monoclonal antibody, currently used as a second-line treatment for gastric cancer.
CASE SUMMARY A 43-year-old man visited our hospital with the complaint of jaundice. He was diagnosed with inoperable advanced gastric cancer owing to invasion of the hepatic hilum by the tumor. After percutaneous transhepatic biliary drainage (PTBD) and stent placement, capecitabine and oxaliplatin were administered as first-line palliative chemotherapy. The tumor progressed, and paclitaxel and ramucirumab were administered as second-line chemotherapy. However, on the first day of the second cycle, the patient suddenly developed dyspnea and pneumonia. BBF was diagnosed on the basis of the presence of bilious sputum and the results of computed tomography, and PTBD was repeated.
CONCLUSION This is the first report of BBF after administration of the new antiangiogenic agent ramucirumab.
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Affiliation(s)
- Hong-Beum Kim
- Department of Premedical Course, Chosun University School of Medicine, Dong-gu, Gwangju 501-717, South Korea
| | - Yong Sub Na
- Department of Internal Medicine, Pulomonology, Chosun University Hospital, Dong-gu, Gwangju 501-717, South Korea
| | - Hee-Jeong Lee
- Department of Internal Medicine, Hemato-oncology, Chosun University Hospital, Dong-gu, Gwangju 501-717, South Korea
| | - Sang-Gon Park
- Department of Internal Medicine, Hemato-oncology, Chosun University Hospital, Dong-gu, Gwangju 501-717, South Korea
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Abelleira R, Toubes ME, Alegría AMD, Valdés L. Late biliobronchial fistula. Pulmonology 2018; 24:317-320. [DOI: 10.1016/j.pulmoe.2018.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 08/04/2018] [Indexed: 11/25/2022] Open
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Shim JR, Han SS, Park HM, Lee EC, Park SJ, Park JW. Two cases of bronchobiliary fistula: Case report. Ann Hepatobiliary Pancreat Surg 2018; 22:169-172. [PMID: 29896580 PMCID: PMC5981149 DOI: 10.14701/ahbps.2018.22.2.169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/01/2017] [Accepted: 01/14/2018] [Indexed: 12/30/2022] Open
Abstract
A bronchobiliary fistula, or a biliobronchial fistula (BBF), is a rare condition. It results from an abnormal connection between the biliary and bronchial trees, and is characterized by pathognomonic bilious sputum with suspicious pneumonia. Traditionally, an infectious disease, such as a hydatid infection, has been known to cause a BBF, but BBFs have recently become associated with tumors. In every case, procedures and treatments differ between centers, from simple conservative management to invasive surgical procedures. This case report presents two patients who had BBF after liver resection. Symptoms of each patients were treated and controlled successfully by percutaneous transhepatic biliary drainage tube insertion. We hope that this report helps in the management of BBF in other cases.
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Affiliation(s)
- Jae Ryong Shim
- Center for Liver Cancer, National Cancer Center, Goyang, Korea
| | - Sung-Sik Han
- Center for Liver Cancer, National Cancer Center, Goyang, Korea
| | - Hyung Min Park
- Center for Liver Cancer, National Cancer Center, Goyang, Korea
| | - Eung Chang Lee
- Center for Liver Cancer, National Cancer Center, Goyang, Korea
| | - Sang-Jae Park
- Center for Liver Cancer, National Cancer Center, Goyang, Korea
| | - Joong-Won Park
- Center for Liver Cancer, National Cancer Center, Goyang, Korea
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Pinsker N, Papoulas M, Sodergren M, Harrison P, Heaton N, Menon K. Successful endoscopic management of a persistent bronchobiliary fistula with Histoacryl ®/Lipiodol ® mixture. Ann R Coll Surg Engl 2018; 100:e73-e77. [PMID: 29543060 PMCID: PMC5958863 DOI: 10.1308/rcsann.2018.0026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2017] [Indexed: 12/27/2022] Open
Abstract
Introduction A bronchobiliary fistula (BBF) following liver directed therapy (resection/ablation) is a rare complication in which an abnormal communication between the biliary tract and bronchial tree is formed. This case report describes the successful management of a persistent BBF following multiple liver wedge resections and microwave ablation in a patient with a metastatic neuroendocrine tumour of the terminal ileum. Case history A 69-year-old man presented with unexplained weight loss and was subsequently diagnosed with a neuroendocrine tumour of the terminal ileum and liver metastasis. Following elective right hemicolectomy and multiple bilobar liver wedge resections combined with liver microwave ablation, he developed an early bile leak. A month later, a right subphrenic collection was identified and four months following surgery, biloptysis was noted. Numerous attempts with endoscopic retrograde biliary drainage (ERBD) failed to achieve sufficient drainage. The patient was treated successfully with endoscopic injection of a mixture of Histoacryl® glue (B Braun, Sheffield, UK) and Lipiodol® (Guerbet, Solihull, UK). There was no evidence of the BBF one year following intervention. Conclusions This novel approach for persistent BBF management using endoscopic Histoacryl® glue embolisation of the fistula tract should be considered either as an adjunct to ERBD or when biliary tract decompression by drainage and/or sphincterotomy fails, prior to proceeding with surgical interventions.
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Affiliation(s)
- N Pinsker
- King’s College Hospital NHS Foundation Trust, UK
| | - M Papoulas
- King’s College Hospital NHS Foundation Trust, UK
| | | | - P Harrison
- King’s College Hospital NHS Foundation Trust, UK
| | - N Heaton
- King’s College Hospital NHS Foundation Trust, UK
| | - K Menon
- King’s College Hospital NHS Foundation Trust, UK
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Percutaneous Transhepatic Embolization of a Bronchobiliary Fistula Developing Secondary to a Biloma After Conventional Transarterial Chemoembolization in a Patient with Hepatocellular Carcinoma. Cardiovasc Intervent Radiol 2015; 39:628-31. [PMID: 26510660 DOI: 10.1007/s00270-015-1224-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 09/14/2015] [Indexed: 12/17/2022]
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Jung GO, Park DE. Successful percutaneous management of bronchobiliary fistula after radiofrequency ablation of metastatic cholangiocarcinoma in a patient who has a postoperative stricture of hepaticojejunostomy site. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2012; 16:110-4. [PMID: 26388918 PMCID: PMC4575004 DOI: 10.14701/kjhbps.2012.16.3.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 07/30/2012] [Accepted: 08/02/2012] [Indexed: 11/17/2022]
Abstract
Bronchobiliary fistula (BBF) is a rare condition that is defined as an abnormal communication between the biliary system and bronchial tree. Furthermore, a BBF is an extremely rare complication of radiofrequency ablation (RFA). A 54 year-old man with a history of extrahepatic biliary cancer had been suffering with a benign stricture of hepaticojejunostomy site and was treated with RFA for metastatic cholangicarcinoma. In this report, we describe a patient with BBF complicated by an abscess which occurred after RFA. He was treated by placement of external drainage catheter into the liver abscess and percutaneous transhepatic biliary drainage (PTBD) into the right intrahepatic duct. After 6 weeks, a complete obliteration of the BBF was confirmed by a repeated follow-up of computed tomography scan and cholangiography through PTBD.
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Affiliation(s)
- Gum O Jung
- Department of Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Dong Eun Park
- Department of Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
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Liao GQ, Wang H, Zhu GY, Zhu KB, Lv FX, Tai S. Management of acquired bronchobiliary fistula: A systematic literature review of 68 cases published in 30 years. World J Gastroenterol 2011; 17:3842-9. [PMID: 21987628 PMCID: PMC3181447 DOI: 10.3748/wjg.v17.i33.3842] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2010] [Revised: 01/22/2011] [Accepted: 01/29/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To outline the appropriate diagnostic methods and therapeutic options for acquired bronchobiliary fistula (BBF).
METHODS: Literature searches were performed in Medline, EMBASE, PHMC and LWW (January 1980-August 2010) using the following keywords: biliobronchial fistula, bronchobiliary fistula, broncho-biliary fistula, biliary-bronchial fistula, tracheobiliary fistula, hepatobronchial fistula, bronchopleural fistula, and biliptysis. Further articles were identified through cross-referencing.
RESULTS: Sixty-eight cases were collected and reviewed. BBF secondary to tumors (32.3%, 22/68), including primary tumors (19.1%, 13/68) and hepatic metastases (13.2%, 9/68), shared the largest proportion of all cases. Biliptysis was found in all patients, and other symptoms were respiratory symptoms, such as irritating cough, fever (36/68) and jaundice (20/68). Half of the patients were treated by less-invasive methods such as endoscopic retrograde biliary drainage. Invasive approaches like surgery were used less frequently (41.7%, 28/67). The outcome was good at the end of the follow-up period in 28 cases (range, 2 wk to 72 mo), and the recovery rate was 87.7% (57/65).
CONCLUSION: The clinical diagnosis of BBF can be established by sputum analysis. Careful assessment of this condition is needed before therapeutic procedure. Invasive approaches should be considered only when non-invasive methods failed.
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