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Percutaneous Treatment of Bronchobiliary Fistula: Report of a Successful Transhepatic Embolization and a Decision-Making Strategy Driven by Systematic Literature Review

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Abstract

Bronchobiliary fistula is a rare condition characterized by bile leaking into the bronchial tree causing biliptysis. It may arise from liver infection or as a consequence of resection and thermal ablation of cancer. Currently, there is no consensus about the treatment strategy. Surgery is considered the main therapy by most authors. However, this systematic literature review shows that the success rate of percutaneous treatments may reach 75%. Adding to such evidence, we also report the case of a woman affected by iatrogenic bronchobiliary fistula secondary to liver thermal ablation, successfully treated with percutaneous drainage plus embolization. Summarizing these results, we encourage the percutaneous management of bronchobiliary fistula by providing a 3-step decision-making algorithm, aimed at reducing the need for major surgery.

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The authors did not receive support from any organization for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants or other support was received.

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  1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy

    Angela Ammirabile & Dario Angelo Rizzo

  2. Humanitas Clinical and Research Center – IRCCS, Via Manzoni, 56, Rozzano, 20089, Milan, Italy

    Angela Ammirabile, Dario Angelo Rizzo, Vittorio Pedicini & Ezio Lanza

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  1. Angela Ammirabile
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  2. Dario Angelo Rizzo
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  4. Ezio Lanza
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Correspondence to Ezio Lanza.

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Ethical approval was waived by the Local Ethics Committee of Humanitas University in view of the retrospective nature of the study, and all the procedures being performed were part of the routine care. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Ammirabile, A., Rizzo, D.A., Pedicini, V. et al. Percutaneous Treatment of Bronchobiliary Fistula: Report of a Successful Transhepatic Embolization and a Decision-Making Strategy Driven by Systematic Literature Review. Cardiovasc Intervent Radiol 44, 1005–1016 (2021). https://doi.org/10.1007/s00270-021-02837-x

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