膈邻近肝癌消融后并发支气管胆瘘：病例报告及文献复习。
Bronchobiliary fistula after ablation of hepatocellular carcinoma adjacent to the diaphragm: Case report and literature review.
机构信息
Department of Minimal invasive intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
Department of Gastroenterology, Huangpu People's Hospital, Zhongshan, China.
出版信息
Thorac Cancer. 2020 May;11(5):1233-1238. doi: 10.1111/1759-7714.13380. Epub 2020 Mar 9.
BACKGROUND
Bronchobiliary fistula is a rare, but life-threatening complication after ablation of hepatocellular carcinoma. Few cases of bronchobiliary fistula have been reported and the treatment is controversial.
METHODS
From 2006 to 2019, a total of 11 patients were diagnosed with bronchobiliary fistula after ablation and received nonsurgical treatment.
RESULTS
All 11 patients presented with cough and bilioptysis. There were only two patients in which MRI revealed an obvious fistulous tract connecting the pleural effusion and biliary lesions. Pleural effusion, liver abscess and hepatic biloma were found in other patients. Three patients died of uncontrolled bronchobiliary fistula.
CONCLUSIONS
Bronchobiliary fistula is a rare post-ablation complication but should be taken into consideration in clinical decisions. Minimally invasive interventional treatment is a relatively effective means of dealing with bronchobiliary fistula, but as for the more severe cases, greater clinical experience is required.
背景
支气管胆道瘘是肝癌消融术后罕见但危及生命的并发症。目前报道的支气管胆道瘘病例较少，治疗方法存在争议。
方法
2006 年至 2019 年，共有 11 例患者被诊断为消融术后支气管胆道瘘并接受非手术治疗。
结果
11 例患者均表现为咳嗽和胆漏。只有 2 例患者的 MRI 显示明显的瘘管连接胸腔积液和胆道病变。其他患者发现胸腔积液、肝脓肿和肝血肿。3 例患者因支气管胆道瘘无法控制而死亡。
结论
支气管胆道瘘是消融术后罕见的并发症，但在临床决策中应予以考虑。微创介入治疗是处理支气管胆道瘘的一种相对有效的方法，但对于更严重的病例，需要更多的临床经验。
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