Fukuyama Sotatsu, Okochi Masayuki, Komuro Yuzo, Sakao Yukinori, Sano Keiji
Department of Plastic and Reconstructive Surgery, Teikyo University, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2020 Nov 24;8(11):e3199. doi: 10.1097/GOX.0000000000003199. eCollection 2020 Nov.
Surgical treatment of bronchobiliary fistula (BBF) is difficult. A 47-year-old woman presented with a cough with yellow yielding sputum due to BBF. The patient had the adhesion of the liver, diaphragm, and lung. We performed liver, diaphragm, and lung resections. Patient had a large defect of diaphragm. Diaphragm reconstruction was performed using a pedicled reverse latissimus dorsi muscle flap. No flap necrosis was observed. Seven months after surgery, the patient did not present yellow yielding sputum and the BBF was not observed in the computed tomography. This surgical procedure was useful for treating the diaphragm defect both safely and easily. We believe that the reverse pedicled latissimus dorsi muscle flap is a reliable alternative for large diaphragm reconstruction after severe BBF.
支气管胆管瘘（BBF）的外科治疗具有挑战性。一名47岁女性因BBF出现咳嗽并咳出黄色痰液。该患者存在肝脏、膈肌和肺部粘连。我们进行了肝脏、膈肌和肺叶切除。患者膈肌存在大的缺损，采用带蒂背阔肌肌皮瓣进行膈肌重建。未观察到皮瓣坏死。术后7个月，患者未咳出黄色痰液，计算机断层扫描未发现BBF。该手术方法安全简便，对治疗膈肌缺损有效。我们认为，带蒂背阔肌肌皮瓣是严重BBF后大面积膈肌重建的可靠选择。
