Video-assisted Thoracoscopic Resection of a Congenital Tracheobiliary Fistula in a Neonate: Technical Report and Review of the Literature

Abstract

Background: Congenital tracheobiliary or bronchobiliary fistulae are rare developmental malformations associated with high morbidity and mortality primarily because of concomitant anomalies as well as delays in diagnosis. Technical Report: We report a case of a neonate who presented with bilious emesis and progressive respiratory failure requiring bronchoscopy and fluoroscopic bronchography for diagnosis with successful management through video-assisted thoracoscopic surgery. We also review the published literature on tracheobiliary fistula. Conclusion: Use of video-assisted thoracoscopic surgery for fistula resection has been reported in only one other neonate and provides a clinically less invasive option compared with open surgical ligation and resection. To our knowledge, this is the first English language report of thoracoscopic resection in a neonate with congenital tracheobiliary fistula.

Diagnosis of congenital bronchobiliary fistula in children by bilirubin crystallization in the bronchoalveolar lavage fluid: A case report and literature review

“…Patients usually have chronic wet coughing, recurrent wheezing, shortness of breath and growth retardation [12]. CBBF has usually been misdiagnosed as an esophagotracheal fistula, gastroesophageal reflux, aspiration pneumonia, tracheoesophageal fistula or high intestinal obstruction [30,31].…”

Minimally invasive resection of congenital tracheobiliary fistula with thoracoscopic cholangiography

“…A minimally invasive thoracoscopic approach has been associated with shorter hospital stay, less postoperative pain, and reduced rate of surgical-site infection for other indications in the pediatric population, and, therefore, is an attractive alternative to thoracotomy in this particular population. To date, there have only been 2 other reports of thoracoscopic resection for a congenital tracheobiliary fistula in a pediatric patient, 4 , 5 one of which was 3.5 years old and the other a neonate. However, we report a new technique for intraoperative confirmation of biliary outflow, using intraoperative thoracoscopic cholangiography at time of thoracoscopic resection which is essential to avoiding significant hepatic morbidity.…”

Congenital bilio-bronchial fistula in an adult: a review of literature and video demonstration of laparoscopic fistula tract excision

“…As a result, 42 cases were reviewed and data on demographic details, type of fistula, associated anomaly, management, and reported outcomes were collected. The data was abstracted into the evidence table template ( Table 1 [ 1 - 39 ]).…”