Biliothoracic Fistula after Microwave Ablation of Liver Metastasis : Literature Review

Abstract

Microwave ablation is a safe and effective interventional approach, widely used in the treatment of unresectable primary or metastatic hepatic lesions. Thoracobiliary fistula is a rare postablation complication that can be treated with a conservative or surgical approach. We reviewed aetiology, pathogenesis, clinical picture, diagnostic possibilities, and therapeutic options for biliothoracic fistula developed after microwave ablation of liver metastasis. Furthermore, we reported our experience of successful conservative management of a nonhealing thoracobiliary fistula occurred after percutaneous thermal ablation of colorectal cancer liver metastasis. Our case supports a conservative approach based on percutaneous biliary system decompression and synthetic glue embolization for the treatment of combined biliopleural and biliobronchial fistula.

Use heat with caution! Pleurobiliary fistula after hepatocellular carcinoma microwave ablation in lymphoma patient: A case study

“…This is a relatively safe procedure, but it may result in a variety of consequences, such as vascular injury, biliary damage, and infection. TBF is extremely uncommon [3] . The prevalence of biliary tract thermal ablation complications (such as biliary strictures, bilomas, and bile leaks) varies from 0.1% to 12% [4] .…”

“…There have been roughly 16 articles published on TBF following thermal ablation therapy since 2002, according to a literature analysis [ 3 , 4 , 7 , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] ]. The age of these patients ranged from 38 to 76 years.…”

“…Other methods, such as percutaneous transhepatic cholangiography, endoscopic retrograde cholangiopancreatography, CT, or magnetic resonance cholangiopancreatography might be helpful for diagnosis. Similarly, 3 of the 16 reported cases are complications of Microwave ablation, while the others are complications of radiofrequency ablation [ 3 , 4 , 18 ].…”

Clinical Impact of SPECT/CT in Evaluation of Abdominothoracic Fistula

“…A 55-year-old man with hepatocellular carcinoma presented newly developed right pleural effusion 1 month after transcatheter arterial chemoembolization. [7][8][9] After insertion of the chest tube, the amount of exudation decreased, but yellow exudate was discharged through the tube removal site. Because biliofistula was suspected, hepatobiliary scan was performed to check bile flow.…”

Complications Associated with Image-Guided Percutaneous Thermal Ablation of Liver Tumors

“…Biliary fistulas to adjacent organs are rare and most of the literatures regarding these types of complications are case reports, reflecting the rarity of biliary type complications. [20][21][22][23][24][25] Biliary pleural fistulas have been described with RFA 22 and MWA of hepatic lesions 25,26 and usually present as bilious effusions (►Fig. 5).…”