Biliobronchial Fistula Caused by Microwave Coagulation Therapy for a Recurrent Metastatic Liver Tumor

Yutaka Ozeki, Yasuhiro Sumi, Takuya Yamada, Kimi Yamauchi, Naomasa Yoshida and Yasutaka Oda

Department of Surgery, Tosei National Hospital

After microwave coagulation therapy (MCT) for a recurrent metastatic liver tumor, a biloma and biliobronchial fistula were encountered. A 61-year-old man underwent sigmoidectomy and extended right hepatic lobectomy for sigmoid colon cancer concomitant with multiple liver metastases in September of 1996. He also underwent microwave coagulation therapy for a recurrent metastatic liver tumor in May of 1997. Two months later, he was admitted to our hospital because of jaundice. Under a diagnosis of biloma, percutaneous drainage of the biloma and bile duct were performed. Cholangiography revealed bile leakage from the left intrahepatic bile duct. To correct stenosis of the left hepatic duct, a metallic stent was placed. In May of 1998, he had biloptysis and a biliobronchial fistula was demonstrated by fistulography from the right subphrenic drainage. The fistula was closed once but soon recurred. Therefore, medial segmentectomy and hepaticojejunostomy were performed in August. His postoperative course was uneventful. The biliobronchial fistula is a complication of MCT which should be kept in mind.

Key words
biliobronchial fistula, microwave coagulation therapy, metastatic liver tumor

Reprint requests
Yutaka Ozeki Department of Surgery, Tosei National Hospital 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka-ken, 411-8611 JAPAN

Accepted
June 22, 1999

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