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肝细胞癌治疗所致获得性支气管胆管瘘的选择性支气管封堵术:病例系列

Selective bronchial occlusion for acquired bronchobiliary fistula caused by treatment of hepatocellular carcinoma: A case series.

作者信息

Zhao Bi, Huang Rui Chen, Xia Yang, Dong Yuchao, Huang Haidong, Zhao Lijun, Zhang Wei

机构信息

Department of Respiratory and Critical Care Medicine the First Affiliated Hospital of Second Military Medical University Shanghai China.

Center of Critical Care Medicine the First Affiliated Hopital of Second Military Medical University Shanghai China.

出版信息

Respirol Case Rep. 2024 Jul 30;12(8):e01440. doi: 10.1002/rcr2.1440. eCollection 2024 Aug.

Abstract

Acquired bronchobiliary fistula (ABBF) is very rare among the complications that occur in patients with hepatocellular carcinoma (HCC) after treatment. Although surgery and drainage have been the main methods for treating ABBF for a long time, they are not entirely suitable for patients with refractory ABBF resulting from HCC therapy. In this study, we present four cases of ABBF caused by HCC treatment, who were treated using selective bronchial occlusion (SBO). Among the 4 patients with ABBF treated with SBO, 3 cases successfully blocked ABBF with SBO, and the treatment success rate was 75%. All successfully treated patients reported disappearance of symptoms of bilioptysis and cough was alleviated. No life-threatening adverse reactions were reported following SBO intervention, and no deaths occurred. We believe that the use of video bronchoscopy to place a self-made silicone plug in the bronchus to treat refractory ABBF is a feasible palliative treatment, which can significantly improve the condition of ABBF patients.

摘要

获得性支气管胆管瘘(ABBF)在肝细胞癌(HCC)患者治疗后发生的并发症中非常罕见。尽管手术和引流长期以来一直是治疗ABBF的主要方法,但它们并不完全适用于HCC治疗导致的难治性ABBF患者。在本研究中,我们报告了4例由HCC治疗引起的ABBF病例,这些患者采用选择性支气管封堵术(SBO)进行治疗。在4例接受SBO治疗的ABBF患者中,3例通过SBO成功封堵了ABBF,治疗成功率为75%。所有成功治疗的患者均报告咯痰症状消失,咳嗽减轻。SBO干预后未报告危及生命的不良反应,也未发生死亡。我们认为,使用视频支气管镜在支气管内放置自制硅胶塞治疗难治性ABBF是一种可行的姑息治疗方法,可显著改善ABBF患者的病情。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c16f/11289238/45a429bea41f/RCR2-12-e01440-g002.jpg

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