In:
HPB Surgery, Hindawi Limited, Vol. 2011 ( 2011-09-22), p. 1-4
Kurzfassung:
Background .
Biliobronchial fistula (BBF) is a rare complication in the natural history of liver
hydatid disease by Echinococcus
granulosus . We present a case of BBF
after resection of a giant liver hydatid cyst in a 72-year-old woman. Case
Report . A total cystpericystectomy was
done, leaving the left lateral section of the liver that was fixed to the diaphragm.
Postoperatively, the patient developed obstructive jaundice. An ERCP showed an
obstruction at the junction of the left biliary duct and the main biliary duct and contrast
leak. At reoperation, the main duct was ischemic, likely due to torsion along its longitudinal
axis. A hepatotomy was done at the hilar plate, and the biliary duct was dissected and
anastomosed to a Roux-en-Y jejunal loop. She was discharged without complications. Five months
later, the patient developed cholangitis and was successfully treated with antibiotics. However,
she suffered repeated respiratory infections, and four months later she was admitted to the
hospital with fever, cough, bilioptysis, and right lower lobe pneumonia. The diagnosis of BBF
was confirmed with Mebrofenin scintigraphy. At transhepatic cholangiography,
bile duct dilation was seen, with a biliothoracic leak. She underwent dilatation
of cholangiojejunostomy stricture with placement of an external-internal catheter. The
catheter was removed 3.5 months later, and two years later the patient remains in very good
condition. Conclusion . An
indirect treatment of the BBF by percutaneous transhepatic dilation of the biliary stenosis
avoided a more invasive treatment, with satisfactory outcome.
Materialart:
Online-Ressource
ISSN:
0894-8569
,
1607-8462
Sprache:
Englisch
Verlag:
Hindawi Limited
Publikationsdatum:
2011
ZDB Id:
2031561-2
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