Endoscopic management of biliocutaneous fistula after percutaneous radiofrequency ablation therapy for hepatocellular carcinoma.
Our patient was a 70-year-old man with hepatocellular carcinoma (HCC) and liver cirrhosis (Child-Pugh B). He had a history of distal gastrectomy with Billroth II reconstruction for duodenal ulcer and hepatectomy for HCC. One month after percutaneous radiofrequency ablation (RFA) for recurrent HCC, biliocutaneous fistula was observed. The cholangiogram demonstrated leakage of contrast material from an intrahepatic duct into the fistula, and a nasobiliary catheter was placed. Subsequently, the discharge of bile steadily decreased and stopped. Follow-up cholangiogram revealed no evidence of bile leakage. Biliocutaneous fistula is an extremely rare complication after percutaneous RFA, and the present case report suggests that endoscopic drainage is the first-line therapy for bile leaks after RFA.
Tsujino
Takeshi
T
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, Tokyo, Japan. tsujinot-int@h.u-tokyo.ac.jp
Sasahira
Naoki
N
Hirano
Kenji
K
Tateishi
Ryosuke
R
Isayama
Hiroyuki
H
Tada
Minoru
M
Shiina
Shuichiro
S
Yoshida
Haruhiko
H
Kawabe
Takao
T
Omata
Masao
M
D000368:Aged; D001658:Biliary Fistula / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D014057:Tomography, X-Ray Computed