Biliothorax: Review of 3 Centers Experience

Abrar G Najjar, Lamees A Maghrabi, Ibtihal T Yamani and Sameh I Sersar

Umm Al-Qura University, Saudi Arabia
IBN Sinai Medical College, Saudi Arabia
Mansoura University, Egypt and King Abdullah Medical Ciy, Makkah, Saudi Arabia

^*Correspondance to: Sameh I Sersar 

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Abstract:

Introduction: Biliothorax is the accumulation of bile in the pleural cavity. Congenital bronchobiliary or pleurobiliary fistulas, hydatid disease and or liver abscess whether echinococcosis and or amoebic abscess, pyogenic, bile tracts obstruction, blunt and or penetrating thoraco-abdominal trauma, liver resection, radiofrequency ablation, bile duct stricture and radiotherapy may be the accused aetiology of such entity. This study aims at reviewing our experience in King Abdullah Medical City; Makkah, King Fahad Central Hospital Jazan; Saudi Arabia and Arar Central Hospital; Saudi Arabia in the management of cases of biliothorax in the last 7 years. Patients and
Methods: The files of 36 cases of biliothorax were reviewed including the available data: age, sex, main presentation, diagnosis, investigations, different modalities of treatment, results and follows up if any.
Results: Thirty six patients were included in this retrospective study. Females were 20, age varied between 16 and 82 years. The aetiology was hepatobiliary tumors in 8, sub-phrenic abscess in 7, and trauma in 7 cases; four of whom were iatrogenic and liver abscess in 6. The main presentation was persistent greenish chest tube drainage of a large amount. The main investigation used was chest x ray, abdominal US, ERCP and MRCP. Interventional radiologist was consulted in 18 cases. Abdominal surgery was required in 11 cases. Thoracic surgery was performed in 7 cases. Four cases died during the study interval.
Conclusion: Biliothorax is a true dilemma mandating a multidisciplinary approach in diagnosis and management. It carries a high morbidity, recurrence, failure of treatment and mortality.

Keywords:

Biliothorax; Truma; Drainage

Cite the Article:

Najjar AG, Maghrabi LA, Yamani IT, Sersar SI. Biliothorax: Review of 3 Centers Experience. World J Surg Surgical Res. 2018; 1: 1014.