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Non-Operative Management of Bronchobiliary Fistula Due to Proximal Migration of Biliary Stent in a Patient With Unresectable Klatskin Tumor
INTRODUCTION: One of the methods for the biliary tree decompression in the case of Klatskin tumor is transpapillary stenting, which could be completed by stent migration in 4% to 10% of cases. Approximately half of the stent migrations are in the proximal direction. In this study, we reported a rare...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411612/ https://www.ncbi.nlm.nih.gov/pubmed/34483694 http://dx.doi.org/10.1177/11795476211043067 |
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author | Tsema, Ievgen Slobodianyk, Viktor Rahushyn, Dmytro Myrhorodskiy, Denys Yurkiv, Oleh Dinets, Andrii |
author_facet | Tsema, Ievgen Slobodianyk, Viktor Rahushyn, Dmytro Myrhorodskiy, Denys Yurkiv, Oleh Dinets, Andrii |
author_sort | Tsema, Ievgen |
collection | PubMed |
description | INTRODUCTION: One of the methods for the biliary tree decompression in the case of Klatskin tumor is transpapillary stenting, which could be completed by stent migration in 4% to 10% of cases. Approximately half of the stent migrations are in the proximal direction. In this study, we reported a rare case of proximal trans-diaphragmatic stent migration to the lower lobe of the right lung with the formation of a biliary-bronchial fistula (BBF). CASE PRESENTATION: A 60-year-old woman was diagnosed with hilar cholangiocarcinoma (type 3B by Bismuth-Corlette) complicated by posthepatic jaundice. To relieve jaundice there were performed endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy, endobiliary stent placement (10 Fr, 150 mm). A restenting (11.5 Fr, 130 mm) was performed in 2.5 months due to endobiliary tube occlusion. In the next 2 months, coughing attacks and biliptysis have appeared in the patient. A CT scan showed penetration of the liver, diaphragm, and lower lobe of the right lung with the proximal part of the stent and caused BBF formation. Anti-inflammatory and antibacterial therapy was administrated for 14 days and BBF was closed. Stent retrieval from the right hemithorax and endobiliary restenting was performed in 9 months after primary stenting. During follow-up, appropriate positioning and functioning of the stent were observed. CONCLUSION: BBF formation is a rare complication of endobiliary stenting, which can be successfully treated by anti-inflammatory and antibiotic therapy, followed by transpapillary stent retrieval. |
format | Online Article Text |
id | pubmed-8411612 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-84116122021-09-03 Non-Operative Management of Bronchobiliary Fistula Due to Proximal Migration of Biliary Stent in a Patient With Unresectable Klatskin Tumor Tsema, Ievgen Slobodianyk, Viktor Rahushyn, Dmytro Myrhorodskiy, Denys Yurkiv, Oleh Dinets, Andrii Clin Med Insights Case Rep Case Report INTRODUCTION: One of the methods for the biliary tree decompression in the case of Klatskin tumor is transpapillary stenting, which could be completed by stent migration in 4% to 10% of cases. Approximately half of the stent migrations are in the proximal direction. In this study, we reported a rare case of proximal trans-diaphragmatic stent migration to the lower lobe of the right lung with the formation of a biliary-bronchial fistula (BBF). CASE PRESENTATION: A 60-year-old woman was diagnosed with hilar cholangiocarcinoma (type 3B by Bismuth-Corlette) complicated by posthepatic jaundice. To relieve jaundice there were performed endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy, endobiliary stent placement (10 Fr, 150 mm). A restenting (11.5 Fr, 130 mm) was performed in 2.5 months due to endobiliary tube occlusion. In the next 2 months, coughing attacks and biliptysis have appeared in the patient. A CT scan showed penetration of the liver, diaphragm, and lower lobe of the right lung with the proximal part of the stent and caused BBF formation. Anti-inflammatory and antibacterial therapy was administrated for 14 days and BBF was closed. Stent retrieval from the right hemithorax and endobiliary restenting was performed in 9 months after primary stenting. During follow-up, appropriate positioning and functioning of the stent were observed. CONCLUSION: BBF formation is a rare complication of endobiliary stenting, which can be successfully treated by anti-inflammatory and antibiotic therapy, followed by transpapillary stent retrieval. SAGE Publications 2021-08-31 /pmc/articles/PMC8411612/ /pubmed/34483694 http://dx.doi.org/10.1177/11795476211043067 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Case Report Tsema, Ievgen Slobodianyk, Viktor Rahushyn, Dmytro Myrhorodskiy, Denys Yurkiv, Oleh Dinets, Andrii Non-Operative Management of Bronchobiliary Fistula Due to Proximal Migration of Biliary Stent in a Patient With Unresectable Klatskin Tumor |
title | Non-Operative Management of Bronchobiliary Fistula Due to Proximal
Migration of Biliary Stent in a Patient With Unresectable Klatskin
Tumor |
title_full | Non-Operative Management of Bronchobiliary Fistula Due to Proximal
Migration of Biliary Stent in a Patient With Unresectable Klatskin
Tumor |
title_fullStr | Non-Operative Management of Bronchobiliary Fistula Due to Proximal
Migration of Biliary Stent in a Patient With Unresectable Klatskin
Tumor |
title_full_unstemmed | Non-Operative Management of Bronchobiliary Fistula Due to Proximal
Migration of Biliary Stent in a Patient With Unresectable Klatskin
Tumor |
title_short | Non-Operative Management of Bronchobiliary Fistula Due to Proximal
Migration of Biliary Stent in a Patient With Unresectable Klatskin
Tumor |
title_sort | non-operative management of bronchobiliary fistula due to proximal
migration of biliary stent in a patient with unresectable klatskin
tumor |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411612/ https://www.ncbi.nlm.nih.gov/pubmed/34483694 http://dx.doi.org/10.1177/11795476211043067 |
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