Bronchobiliary fistula after stenting of biliary duct as the management of iatrogenic bile duct injury during elective cholecystectomy

Acta Chir Belg. 2023 Oct;123(5):544-549. doi: 10.1080/00015458.2022.2049071. Epub 2022 Mar 11.

Abstract

Background: Bronchobiliary fistula is a rare and complex entity defined by an abnormal communication between the biliary and bronchial systems. The etiopathogenesis is not completely understood, but the most common factors implicated are hepatobiliary tumors, biliary obstruction, iatrogenic damage or trauma.

Methods: Here we present a case of a 69-year-old man that developed a bronchobiliary fistula and a pulmonary abscess after migration of a bile duct stent placed as part of the treatment of an iatrogenic bile duct injury that occurred during elective cholecystectomy.

Results: A conservative approach, that included broad-spectrum antibiotic, removal of the stent, and sphincterotomy, was enough for the closure of the fistula and resolution of the symptoms.

Conclusion: We emphasize the importance of prompt recognition of this entity and a concerted therapeutic strategy to optimize the probability of success, avoiding the destructive consequences of the bile in the pulmonary parenchyma and septic complications.

Keywords: Bronchobiliary fistula; bile duct injury; biliary stent; biliptysis; pulmonary abscess.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bile Ducts
  • Biliary Fistula* / diagnosis
  • Biliary Fistula* / etiology
  • Biliary Fistula* / surgery
  • Bronchial Fistula* / diagnostic imaging
  • Bronchial Fistula* / etiology
  • Bronchial Fistula* / surgery
  • Cholangiopancreatography, Endoscopic Retrograde / adverse effects
  • Cholecystectomy / adverse effects
  • Humans
  • Iatrogenic Disease
  • Male
  • Stents / adverse effects