Bronchobiliary fistula after stenting of biliary duct as the management of iatrogenic bile duct injury during elective cholecystectomy

Queirós, Tatiana; Castro, Baltazar de; Ferreira, Ana Reis; Amado, Andreia; Louro, Hugo; Lucas, Maria Conceição; Santos, Jorge E.; Cardoso, Júlio Roquete; Oliveira, Marco

doi:10.1080/00015458.2022.2049071

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…One diagnostic criterion proposed is imaging methods proving BBF or bile accumulations in the pleura (3,7,12). The most sensitive diagnostic methods are endoscopic retrograde cholangiopancreatography, percutaneous transhepaticcholangiography, and a fistulogram of the biliocutaneus fistula (13).…”

Section: Discussionmentioning

confidence: 99%

Case report: Biliobronchial fistula after biliary tract stenosis

et al. 2022

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Biliobronchial fistula (BBF) is a rare abnormality resulting from congenital or acquired communication between the bile ducts and the bronchial tree. Patients often suffer from chronic cough, dyspnea, and bilioptysis, a pathognomonic symptom of this condition. Conservative methods such as less-invasive procedures are gradually consolidating. Nonetheless, surgery remains the primary treatment, especially in more complex cases. We present the case of a 44-year-old woman with a chronic cough, no verified periods of fever, cyclic jaundice, and episodes of yellowish sputum. She had undergone cholecystectomy in 2018 and had been hospitalized several times since for pneumonia treatment. All consequent investigations for mycobacteriosis were negative. When referred to our hospital, she had cyclic jaundice and parenchymal consolidation in the right lower lobe. Suspected bilioptysis motivated the search for a biliobronchial fistula. Magnetic resonance cholangiography (MRC) confirmed stenosis of the biliary tract and fistulous path, and sputum analysis indicated high bilirubin levels. External biliary bypass was performed as an initial conservative and definitive therapy due to the presence of liver cirrhosis. Although BBF is a rare condition when bilioptysis is suspected, a diagnostic investigation should be initiated. Our case study proposes two criteria for diagnosis: an imaging exam demonstrating the fistulous path and confirmation of bilirubin in the sputum or bronchoalveolar lavage (BAL). When diagnosed, surgical correction should be performed.

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Section: Discussionmentioning

confidence: 99%

Case report: Biliobronchial fistula after biliary tract stenosis

et al. 2022

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“… 7 The majority was managed with endoscopic removal and closure, with however high mortality (3 of 11 6 vs 4 of 13 cases 7 ). While migration to unusual sites, such as the pericardium, 8 – 10 bronchial system, 11 and perforation of small bowel, 12 , 13 is limited to few case reports, colonic perforation has been reported in 32 cases since 2000 (Table 1 ), with only 5 cases outside the rectosigmoid colon, in which most perforations occurred because of impaction in thin-walled diverticula.…”

Section: Introductionmentioning

confidence: 99%

The Pierced Colon: When Biliary Stents Go the Wrong Way

Rybinski¹,

Heinrich²,

Zimmerli³

et al. 2023

ACG Case Rep J

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Bowel perforation of biliary stents is a rare complication of biliary stenting. We report the successful endoscopic treatment of a 78-year-old man with a straight biliary plastic stent perforating the ascending colon without underlying structural abnormality in the affected segment. Perforation was detected incidentally during computed tomography; the patient had been under continued antibiotic therapy for liver abscess. Stent extraction was performed by using an endoscopic snare; the site of perforation was closed with through-the-scope clips. The patient remained asymptomatic. In addition, we reviewed published cases of perforated biliary stents and outlined that most perforations are caused by straight plastic stents.

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“…Bronchobiliary fistula (BBF) is a rare complication of infection, trauma, and complex surgical procedures, [1][2][3] which is defined as an abnormal intercommunication between the biliary tract and the bronchial tree, [4] with high mortality and morbidity rate (12.2%). [5,6] Multiple management strategies have been described in the literature including complex surgical procedures, minimally invasive techniques, and systemic treatment.…”

Section: Introductionmentioning

confidence: 99%

Bronchobiliary fistula caused after percutaneous transhepatic biliary drainage treatment: A case report

Lian,

Zhou,

Peng

et al. 2023

Medicine

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Rationale: Percutaneous transhepatic biliary drainage (PTBD) plays a significant role especially in the diagnosis and decompression of bile duct obstruction. However, it is associated with complications such as hemobilia, occlusion of drainage, bile leakage, and even bronchobiliary fistula (BBF). Patient concerns and diagnoses: We herein describe a patient with a complication of BBF caused by long-term indwelling PTBD catheters. She underwent multiple operations including bilioenteric anastomosis, hepatic left lateral lobectomy, and long-term PTBD treatment. Her symptoms were mainly cough, fever, and yellow sputum and her diagnosis was confirmed by sputum culture (bilirubin detection was positive). Interventions and outcomes: The patient recovered uneventfully by minimally invasive treatment, was discharged after 1 week of hospitalization, and the drainage tube was removed 2 weeks later. During 2 years of follow-up, no recurrence of BBF was observed. Lessons: Patients with long-term indwelling PTBD catheters for biliary tract obstruction may lead to BBF. The treatment plan of BBF is tailored to the patient’s individualized characteristics. And minimally invasive treatments might be an effective alternate way for the treatment of BBF. The accurate diagnosis, precision treatment, and multidisciplinary team play important roles in the treatment of BBF.

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Bronchobiliary fistula after stenting of biliary duct as the management of iatrogenic bile duct injury during elective cholecystectomy

Cited by 3 publications

References 16 publications

Case report: Biliobronchial fistula after biliary tract stenosis

Case report: Biliobronchial fistula after biliary tract stenosis

The Pierced Colon: When Biliary Stents Go the Wrong Way

Bronchobiliary fistula caused after percutaneous transhepatic biliary drainage treatment: A case report

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