Endoscopic management of biliopleural fistula and biloma after percutaneous radiofrequency ablation of liver metastasis

Pende, Vito; Marchese, Michele; Mutignani, Massimiliano; Polinari, Umberto; Allegri, C.; Greco, R.; Costamagna, Guido

doi:10.1016/j.gie.2006.12.023

Cited by 14 publications

(19 citation statements)

References 11 publications

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“…A large tumor, close to the hilum or hepatic dome, has been found to be a predisposing factor of BBF following RFA (8,11). In the present case, a liver tumor measuring 44x34 mm, which was located near the right hepatic bile duct and dome, was treated with RFA, and the ablation zone was found to have reached a size of 75x54 mm on MRI at 1 month after RFA.…”

Section: A B C Dmentioning

confidence: 48%

“…Contrast-enhanced magnetic resonance cholangiopancreatography is a non-invasive technique that may be used to diagnose BBF and can directly detect the fistula tract (16). Invasive examinations, such as percutaneous transhepatic cholangiography or endoscopic retrograde cholangiopancreatography, can reveal the abnormal fistula tract between the biliary system and the bronchial tree, which is considered to be the most direct evidence to suggest BBF (8,12). In the present case, the patient's sputum was confirmed to …”

mentioning

confidence: 55%

“…Less invasive treatment procedures include endoscopic or percutaneous biliary drainage or percutaneous biloma drainage (8,13). Most BBFs can be resolved by drainage and biliary tract decompression; however, certain BBFs persist, requiring surgical intervention (9).…”

Section: A B C Dmentioning

confidence: 99%

“…Common complications include subcapsular hematoma, hepatic abscess, biloma, pneumothorax and pleural effusion. Rare complications, such as diaphragmatic necrosis and abscesso-colonic and biliopleural fistula have also been reported (1,8).…”

Section: Introductionmentioning

confidence: 99%

“…Despite the fact that it may not directly display the fistula tract, it can reveal indirect findings, such as pneumonia, subphrenic fluid collection, pleural effusion, liver abscess, biloma and bile duct calculi (8,11,14). Contrast-enhanced magnetic resonance cholangiopancreatography is a non-invasive technique that may be used to diagnose BBF and can directly detect the fistula tract (16).…”

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confidence: 99%

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Delayed bronchobiliary fistula following radiofrequency ablation in a patient with hepatocellular carcinoma: A case report and lesson regarding treatment

et al. 2016

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Abstract. Bronchobiliary fistula (BBF) is a rare complication of radiofrequency ablation (RFA) of hepatocellular carcinoma. The rupture of a biloma following RFA may result in the development of BBF, with their early detection and timely management important in the prevention of BBF. The current study presents a case of BBF, which developed at 17 months after radiofrequency ablation (RFA), due to biloma rupture in a patient with hepatocellular carcinoma. Despite the percutaneous drainage of the biloma following BBF, the persistent fever did not resolve due to biliary infection. Finally, an extensive surgical intervention was performed. The magnetic resonance imaging (MRI) scans that had been performed following RFA were reviewed, and it was found that the biloma and increased bile leakage had presented prior to biloma rupture. For that reason, it is advised that patients who present with biloma following RFA should receive regular follow-up MRI scans. Biloma enlargement could be a predictor for the development of BBF; therefore, timely drainage of an enlarging biloma may be able to prevent this complication.

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Section: A B C Dmentioning

confidence: 48%

mentioning

confidence: 55%

Section: A B C Dmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Delayed bronchobiliary fistula following radiofrequency ablation in a patient with hepatocellular carcinoma: A case report and lesson regarding treatment

et al. 2016

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Nonoperative management of biliopleural fistula following living‐donor liver transplantation: A case report

Kazemi,

Rasekhi,

Nazari

et al. 2023

Clinical Case Reports

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Key Clinical MessageBiliopleural fistula is a rare but serious complication after liver transplantation that should be managed nonoperatively with antibiotics, pleural drainage, decompression of high‐pressure biliary tract, or ultimately surgery in unresponsive cases.AbstractBilious pleural effusion is a rare entity often iatrogenic, following hepatobiliary surgeries and biliary interventions, and has been reported only in a limited number of patients after liver transplantation. A 5‐year‐old girl underwent living donor liver transplantation due to progressive familial intrahepatic cholestasis. At the 7th day of the postoperative course, due to increased liver enzymes and bilirubin levels and intrahepatic bile duct dilatation on sonography, Magnetic Resonance Cholangiopancreaticography followed by a liver biopsy were performed; the findings demonstrated moderate intrahepatic bile duct dilatation and moderate cellular rejection associated with mild cholestasis, respectively. The patient was therefore administered a pulse of methylprednisolone; however, due to fever, peritonitis and also sonographic evidence of infected biloma collection adjacent to the transplanted liver, the patient underwent surgery. Laparotomy and peritoneal washout were performed and a Jackson‐Pratt drain was inserted adjacent to the liver cut surface. Succeeding tachypnea on 28th post day, led to detection of right side massive pleural effusion on chest Xray and hence thoracostomy tube was inserted. A diagnosis of biliopleural fistula was established and broad‐spectrum intravenous antibiotic therapy was started, followed by cholangiography, fistula closure, and bile duct stricture ballooning and internal‐external biliary catheter insertion. The patient was discharged in generally good condition on the 50th posttransplant day. The diagnosis of biliopleural fistula is facilitated with the utilization of chest imaging and pleural fluid analysis, however, a high index of suspicion is required.

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Use heat with caution! Pleurobiliary fistula after hepatocellular carcinoma microwave ablation in lymphoma patient: A case study

Abdurabuh

Khairo²,

Bakhsh³

et al. 2022

Radiology Case Reports

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Endoscopic management of biliopleural fistula and biloma after percutaneous radiofrequency ablation of liver metastasis

Cited by 14 publications

References 11 publications

Delayed bronchobiliary fistula following radiofrequency ablation in a patient with hepatocellular carcinoma: A case report and lesson regarding treatment

Delayed bronchobiliary fistula following radiofrequency ablation in a patient with hepatocellular carcinoma: A case report and lesson regarding treatment

Nonoperative management of biliopleural fistula following living‐donor liver transplantation: A case report

Use heat with caution! Pleurobiliary fistula after hepatocellular carcinoma microwave ablation in lymphoma patient: A case study

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