Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy.
Humanitas Clinical and Research Center - IRCCS, Via Manzoni, 56, Rozzano, 20089, Milan, Italy.
Cardiovasc Intervent Radiol. 2021 Jul;44(7):1005-1016. doi: 10.1007/s00270-021-02837-x. Epub 2021 Apr 29.
Bronchobiliary fistula is a rare condition characterized by bile leaking into the bronchial tree causing biliptysis. It may arise from liver infection or as a consequence of resection and thermal ablation of cancer. Currently, there is no consensus about the treatment strategy. Surgery is considered the main therapy by most authors. However, this systematic literature review shows that the success rate of percutaneous treatments may reach 75%. Adding to such evidence, we also report the case of a woman affected by iatrogenic bronchobiliary fistula secondary to liver thermal ablation, successfully treated with percutaneous drainage plus embolization. Summarizing these results, we encourage the percutaneous management of bronchobiliary fistula by providing a 3-step decision-making algorithm, aimed at reducing the need for major surgery.
支气管胆瘘是一种罕见的病症，其特征是胆汁漏入支气管树导致胆咳。它可能由肝脏感染或癌症切除和热消融引起。目前，对于治疗策略尚无共识。大多数作者认为手术是主要治疗方法。然而，本系统文献复习表明，经皮治疗的成功率可能达到 75%。在此基础上，我们还报告了一例因肝脏热消融引起的医源性支气管胆瘘患者，采用经皮引流加栓塞治疗成功。总结这些结果，我们鼓励通过提供 3 步决策算法来对支气管胆瘘进行经皮处理，旨在减少对大型手术的需求。
