Bronchobiliary fistula after hepatectomy: A case report and review of the literature

Lazarou,Vasiliki; Moris,Dimitrios; Papalampros,Alexandros; Tsilimigras,Diamantis I.; Karachaliou,Georgia‑Sofia; Petrou,Athanasios

doi:10.3892/mco.2019.1935

Bronchobiliary fistula after hepatectomy: A case report and review of the literature

Authors:
- Vasiliki Lazarou
- Dimitrios Moris
- Alexandros Papalampros
- Diamantis I. Tsilimigras
- Georgia‑Sofia Karachaliou
- Athanasios Petrou
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Affiliations: Nicosia Surgical Department, Division of Hepatobiliary Pancreatic Surgery, Nicosia General Hospital, Nicosia 2029, Cyprus, First Department of Surgery, Laikon General Hospital, University of Athens, Athens 11527, Greece
Published online on: October 15, 2019 https://doi.org/10.3892/mco.2019.1935
Pages: 602-606

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Abstract

Bronchobiliary fistula (BBF) is a rare complication following hepatectomy, and consists of an abnormal intercommunication between the biliary tract and bronchial tree. The management of this rare entity is challenging with limited current evidence to date on how to treat this condition. Herein, a case of BBF following a central hepatectomy and the successive steps of the management was presented. Fourteen months postoperatively, the patient presented to the Oncology Department complaining of new onset fever and expectoration. A computerized tomography scan revealed a BBF and the patient was subsequently referred to our department for further treatment. The surgical team decided that a further operation was required. Using the transabdominal approach, a communication between the initial intrahepatic collection and one inferior lobular bronchus was revealed. Transhiatal removal of fistula was performed with closure of the defect through the abdomen. There was no bile leak through the remaining liver parenchyma. Multidisciplinary management should be considered, taking into consideration the underlying pathology leading to this rare complication. Conservative treatment should be considered first, while surgical resection of the BBF remains an option when other therapies have failed. Surgeons should be aware of this rare complication bile duct injuries during hepatic operations can cause.

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