Bronchobiliary fistula treated by self-expanding ePTFE-covered nitinol stent-graft.
A 71-year-old man, who had undergone right hepatectomy extended to the caudate lobe with terminolateral Roux-en-Y left hepatojejunostomy for a Klatskin tumor, developed bilioptysis 3 weeks postoperatively due to bronchobiliary fistula. Percutaneous transhepatic cholangiography revealed a non-dilated biliary system with contrast medium extravasation to the right subphrenic space through a resected anomalous right posterior segmental duct. After initial unsuccessful internal-external biliary drainage, the fistula was sealed with a VIATORR covered self-expanding nitinol stent-graft placed with its distal uncovered region in the hepatojejunal anastomosis and the proximal ePTFE-lined region in the left hepatic duct. A 10-month follow-up revealed no recurrence of bilioptysis and confirmed the complete exclusion of the bronchobiliary fistula.
Gandini
Roberto
R
Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, Italy.
Konda
Daniel
D
Tisone
Giuseppe
G
Pipitone
Vincenzo
V
Anselmo
Alessandro
A
Simonetti
Giovanni
G
D000368:Aged; D000497:Alloys / Q000627:therapeutic use*; D001658:Biliary Fistula / Q000175:diagnosis* / Q000601:surgery*; D001659:Biliary Tract / Q000000981:diagnostic imaging; D001983:Bronchial Fistula / Q000175:diagnosis* / Q000601:surgery*; D001995:Bronchography / Q000379:methods; D002758:Cholangiography / Q000379:methods; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000601:surgery; D004322:Drainage / Q000379:methods; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D035583:Rare Diseases; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods
D000497:Alloys; C013616:nitinol; D011138:Polytetrafluoroethylene