Treatment of Biliary-Pleural Fistula as a Severe Complication after Percutaneous Transhepatic Biliary Drainage

Dong Lu, Zhi-Yong Zhou, Wei-Fu Lv, Kun Xue and Jie Chai

Department of Interventional Radiology, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, China Department of Interventional Vascular Surgery, Huainan Xinkang Hospital, China

^*Correspondance to: Dong Lu, 

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Abstract:

Introduction: Percutaneous Transhepatic Biliary Drainage (PTBD) is the most commonly used interventional treatment in patients with biliary obstruction. Biliary-Pleural Fistula (BPF) and the formation of bilious pleural effusion is a rare and severe complication of PTBD. We report the successful treatment experience of 2 patients with severe complications of BPF after PTBD. We hope to give reminders to the interventional radiologists and reference in treatment for such cases. Case Report: BPF and the formation of bilious pleural effusion occurred in two patients when the biliary drainage tube was removed after PTBD. Thoracic drainage is the first choice as a conservatively therapy for BPF, and the biliary puncture and drainage were performed. Through thoracentesis to drain bile-like pleural effusion, the existence of BPF and the formation of bilious pleural effusion can be observed. When we performed re-PTBD, the patients were eventually cured. Conclusion: Taking another form of biliary drainage as soon as possible is the most important factor in the successful management of BPF. Accurately judging the lower boundary of the right pleural cavity before PTBD or puncturing the left bile duct can avoid the occurrence of BPF to the greatest extent.

Keywords:

Biliary pleural fistula; Bilious pleural effusion; Percutaneous transhepatic biliary drainage; Complications; Interventional radiology

Cite the Article:

Lu D, Zhou Z-Y, Lv W-F, Xue K, Chai J. Treatment of Biliary-Pleural Fistula as a Severe Complication after Percutaneous Transhepatic Biliary Drainage. World J Surg Surgical Res. 2022;5:1386..