Percutaneous Treatment of Bronchobiliary Fistula: Report of a Successful Transhepatic Embolization and a Decision-Making Strategy Driven by Systematic Literature Review

Cardiovasc Intervent Radiol. 2021 Jul;44(7):1005-1016. doi: 10.1007/s00270-021-02837-x. Epub 2021 Apr 29.

Abstract

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.

Keywords: Biliary fistula; Biliary surgical procedure; Bronchial fistula; Drainage; Embolization; Review; Therapeutic.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Biliary Fistula / therapy*
  • Bronchial Fistula / therapy*
  • Drainage / methods*
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Middle Aged