Portobiliary fistulas are a rare complication of percutaneous transhepatic biliary procedures that could result in hemorrhage or sepsis. Hence we present a case of a transhepatic biliary drainage insertion in a patient with an underlying Bismuth type IV cholangiocarcinoma which resulted in a portobiliary fistula. Portobiliary fistula management is controversial. Moreover, to the best of our knowledge, there are few cases in the English literature reporting successful treatment. This case was successfully managed by controlled transbiliary embolization of a portal branch without compromising the main portal vein or bile ducts. Keywords: Biliary procedures; Cholangiocarcinoma; Embolization; Complications.
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