Endobronchial Watanabe Spigot Placement for Hepatic Abscess and Bronchobiliary Fistula Following Radiofrequency Ablation for Hepatocellular Carcinoma

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 o...

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Published in:Internal medicine (Tokyo, 1992) 1992), 2023-04, Vol.62 (7), p.999-1004, Article 0392-22
Main Authors: Nishioki, Toshihiko, Koyama, Ryo, Okubo, Hironao, Fukuo, Yuka, Takasaki, Yusuke, Yae, Toshifumi, Banno, Takamitsu, Kido, Kenji, Takahashi, Kazuhisa, Shiina, Shuichiro, Ikejima, Kenichi
Format: Article
Language:English
Subjects:
Biliary Fistula - etiology
Biliary Fistula - surgery
Bronchial Fistula - etiology
Bronchial Fistula - surgery
Bronchoscopy
Carcinoma, Hepatocellular - complications
Carcinoma, Hepatocellular - surgery
Case Report
Catheter Ablation - adverse effects
Fistulae
Hepatocellular carcinoma
Humans
Internal medicine
Liver
Liver Abscess - etiology
Liver Abscess - surgery
Liver Neoplasms - complications
Male
Radiofrequency ablation
Radiofrequency Ablation - adverse effects
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Description
Summary: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.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.0392-22