CardioVascular and Interventional Radiology

, Volume 39, Issue 4, pp 628–631 | Cite as

Percutaneous Transhepatic Embolization of a Bronchobiliary Fistula Developing Secondary to a Biloma After Conventional Transarterial Chemoembolization in a Patient with Hepatocellular Carcinoma

  • Hyun Young Kim
  • Se Hwan KwonEmail author
  • Joo Hyeong Oh
  • Jong Soo Shin
  • Seok-Ho Dong
  • Myung Jae Park
  • Sun Jin Park
Letter to the Editor

Dear Sirs,

A 53-year-old male underwent conventional transarterial chemoembolization (TACE) (using a combination of doxorubicin, lipiodol, and gelfoam) twice for treatment of multiple hepatocellular carcinoma (HCC) at our institution. Several tumors were located in the right lobe of the liver. His past medical history was significant and included lung and gastric cancer. He had undergone left lower lung lobectomy to treat a non-small cell lung cancer 4 years prior and subtotal gastrectomy with gastro-jejunostomy (the Billroth II operation) to treat advanced gastric cancer 3 years prior.

One month after the second TACE, the patient presented with general weakness and abdominal pain with fever. An abdominal computed tomography (CT) scan revealed multiple intrahepatic duct (IHD) dilatations and bilomas in the right hepatic lobe (Fig.  1). Multiple percutaneous transhepatic drainages of the intrahepatic biloma and biliary duct drainage were performed to decompress the bilomas and the...


Bile Duct Tace Biliary Drainage Percutaneous Drainage Bile Duct Stricture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with Ethical Standards

Conflict of interest

All authors (Hyun Young Kim, Se Hwan Kwon, Joo Hyeong Oh, Jong Soo Shin, Seok-Ho Dong, Myung Jae Park, Sun Jin Park) have no conflict of interest.

Ethical Approval

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.

Informed Consent

Informed consent was obtained from the patient.


  1. 1.
    Hibi T, Sakamoto Y, Asamura H, et al. Successful resection of hepatocellular carcinoma with bronchobiliary fistula caused by repeated transcatheter arterial embolizations: report of a case. Surg Today. 2007;37:154–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Mukkada RJ, Antony R, Francis JV, et al. Bronchobiliary fistula treated successfully with endoscopic microcoils and glue. Ann Thorac Surg. 2014;98:e33–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Akazawa S, Omagari K, Amenomori M, et al. Bronchobiliary fistula associated with intrahepatic biloma after transcatheter arterial chemoembolization for hepatocellular carcinoma. J Hepatol. 2004;40:1045–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Liao GQ, Wang H, Zhu GY, et al. Management of acquired bronchobiliary fistula: a systematic literature review of 68 cases published in 30 years. World J Gastroenterol. 2011;17:3842–9.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Naumann M, Bonsall R, Gupta R. Chemoembolization with drug-eluting beads complicated by intrahepatic biloma. Semin Intervent Radiol. 2011;28:212–7.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Sakamoto I, Iwanaga S, Nagaoki K, et al. Intrahepatic biloma formation (bile duct necrosis) after transcatheter arterial chemoembolization. AJR Am J Roentgenol. 2003;181:79–87.CrossRefPubMedGoogle Scholar
  7. 7.
    Miyayama S, Yamashiro M, Okuda M, et al. Main bile duct stricture occurring after transcatheter arterial chemoembolization for hepatocellular carcinoma. Cardiovasc Intervent Radiol. 2010;33:1168–79.CrossRefPubMedGoogle Scholar
  8. 8.
    Kim JH, Kim MD, Lee YK, et al. Bronchobiliary fistula treated with histoacryl embolization under bronchoscopic guidance: a case report. Respir Med CME. 2008;1:164–8.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2015

Authors and Affiliations

  • Hyun Young Kim
    • 1
  • Se Hwan Kwon
    • 1
    Email author
  • Joo Hyeong Oh
    • 1
  • Jong Soo Shin
    • 2
  • Seok-Ho Dong
    • 3
  • Myung Jae Park
    • 3
  • Sun Jin Park
    • 4
  1. 1.Department of Radiology, College of MedicineKyung Hee UniversitySeoulRepublic of Korea
  2. 2.Department of RadiologyKyung Hee University Hospital at GangdongSeoulRepublic of Korea
  3. 3.Department of Internal Medicine, College of MedicineKyung Hee UniversitySeoulRepublic of Korea
  4. 4.Department of Surgery, College of MedicineKyung Hee UniversitySeoulRepublic of Korea

Personalised recommendations