Department of Respiratory Medicine, Juntendo University Nerima Hospital, Japan.
Department of Gastroenterology, Juntendo University Nerima Hospital, Japan.
Intern Med. 2023 Apr 1;62(7):999-1004. doi: 10.2169/internalmedicine.0392-22. Epub 2022 Aug 10.
A bronchobiliary fistula (BBF) is an uncommon but severe complication after radiofrequency ablation (RFA). However, the definitive salvage methods are controversial. We herein report a patient with hepatocellular carcinoma with hepatic abscess and BBF following RFA. We also review previous reports of BBF after RFA. The patient was a man in his 70s who underwent RFA for recurrent hepatocellular carcinoma in the subphrenic area. Despite percutaneous transhepatic abscess drainage, bilioptysis persisted. Finally, the BBF was occluded with an endobronchial Watanabe spigot under fiber-optic bronchoscopy. Placing an endobronchial Watanabe spigot should be considered as a salvage therapy for refractory BBF following RFA.
支气管胆瘘（BBF）是射频消融（RFA）后一种罕见但严重的并发症。然而，明确的补救方法存在争议。我们在此报告一例 RFA 后肝脓肿和 BBF 的肝细胞癌患者。我们还回顾了 RFA 后 BBF 的以往报告。患者为 70 多岁男性，因膈下区复发性肝细胞癌接受 RFA 治疗。尽管经皮经肝脓肿引流，但仍存在胆汁漏。最终，在纤维支气管镜下通过支气管内渡边塞子闭塞 BBF。对于 RFA 后难治性 BBF，放置支气管内渡边塞子应被视为一种补救治疗方法。
