Year 2022 / Volume 114 / Number 12
Letter
Bronchial-biliary fistula secondary to cholangiocarcinoma: long-term efficacy of biliary self-expandable metal stent

758-760

DOI: 10.17235/reed.2022.8970/2022

Emanuel Dias, Hélder Cardoso, Pedro Pereira, Pedro Moutinho-Ribeiro, Guilherme Macedo,

Abstract
A 77-year-old female with previous medical history of non-cirrhotic chronic hepatitis B and hepatocellular carcinoma treated with sequential partial hepatectomy followed by transarterial chemoembolization complained of pruritus and jaundice. Magnetic resonance cholangiopancreatography revealed a peri-hilar ill-defined stenosing lesion suggestive of malignancy. Endoscopic retrograde cholangiopancreatography with cholangioscopy confirmed a circumferential peri-hilar stenosis with fragile mucosa and tortuous dilated vessels and biopsies of this area were consistent cholangiocarcinoma. After 3 months, she presented with new-onset dyspnea and bilioptysis and abdominal computed tomography revealed a bronchial-biliary fistula. ERCP was performed to place a self-expandable metal stent in the biliary tract, which resulted in rapid clinical improvement. The patient has been followed for 2 years and remains globally stable with two episodes of worsening of bilioptysis secondary to stent obstruction by lithiasis that were easily resolved with Fogarty balloon-assisted extraction, with rapid improvement. This case demonstrates the long-term efficacy of endoscopic biliary drainage with self-expandable metallic stent for bronchial-biliary fistula in the setting of cholangiocarcinoma. 
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References
1. Takakusagi S, Hoshino T, Takagi H, et al. The development of broncho-biliary fistula after treatment for hepatocellular carcinoma: a report of two cases. Clin J Gastroenterol. 2021;14(1):229-37.
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Citation tools
Dias E, Cardoso H, Pereira P, Moutinho-Ribeiro P, Macedo G. Bronchial-biliary fistula secondary to cholangiocarcinoma: long-term efficacy of biliary self-expandable metal stent. 8970/2022


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Publication history

Received: 28/05/2022

Accepted: 06/06/2022

Online First: 15/06/2022

Published: 12/12/2022

Article Online First time: 18 days

Article editing time: 198 days


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