[1]张志刚 刘新民﹡.胆管支气管瘘的治疗: 6例报告并文献回顾[J].中国微创外科杂志,2016,16(01):42-46.
　Zhang Zhigang,Liu Xinmin..Treatment for Bronchobiliary Fistula: a Report of 6 Cases and Literature Review[J].Chinese Journal of Minimally Invasive Surgery,2016,16(01):42-46.
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胆管支气管瘘的治疗: 6例报告并文献回顾()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
16
期数:
2016年01期
页码:
42-46
栏目:
临床研究
出版日期:
2016-03-18

文章信息/Info

Title:
Treatment for Bronchobiliary Fistula: a Report of 6 Cases and Literature Review
作者:
张志刚 刘新民﹡
（北京大学第一医院老年病科，北京100034）
Author(s):
Zhang Zhigang;  Liu Xinmin.
Department of Geriatrics, Peking University First Hospital, Beijing 100034, China
关键词:
胆管支气管瘘; 胆汁
Keywords:
Bronchobiliary fistula; Bile
文献标志码:
A
摘要:
目的探讨胆管支气管瘘（bronchobiliary fistula，BBF）的临床表现、影像学特征、诊断及治疗方法。方法回顾分析1975年12月~2007年6月我院收治的6例BBF的临床资料，总结患者的临床及影像学特征。结果6例均为获得性BBF，其中继发于肝脓肿3例，肝破裂伤2例，肝癌术后1例。发热6例，咳嗽6例，咳胆汁6例，呼吸困难4例，右上腹痛4例，胸痛2例；查体：右上腹压痛4例、右下肺叩浊3例、异常呼吸音3例、肝区叩痛2例。6例接受抗感染治疗及经皮经肝胆管/脓肿引流，1例另行瘘管栓塞治疗，6例病情改善。1例痊愈，1例长期置管引流并于1年后死于胆道出血，4例失访。结论咳胆汁是BBF的特征性表现，微创治疗可作为首选治疗方法。
Abstract:
ObjectiveTo describe the clinical and radiological characteristics, diagnosis, and treatment of bronchobiliary fistula (BBF). MethodsFrom December 1975 to June 2007, 6 patients with BBF were successfully diagnosed and treated in this hospital. A retrospective analysis was performed and literatures on the disease were reviewed. Results All the cases were acquired BBF. The etiologies included liver abscess (3 cases), trauma (2 cases), and postoperative complication of hepatic carcinoma (1 case). The main symptoms the patients complained of were fever (6 cases), cough (6 cases), biliptysis (6 cases), dyspnea (4 cases), abdominal pain in right quadrant (4 cases) and pleuritic chest pain (2 cases). On physical examination, tenderness in the right upper quadrant (4 cases), dull percussion (3 cases), abnormal breath sounds (3 cases), percussion tenderness over hepatic region (2 cases) were main abnormalities. All the 6 patients underwent antibiotics treatment and percutaneous transhepatic biliary/abscess drainage. One of them underwent radiological coil embolization of the fistula. All the patients showed clinical improvement. Followup survey showed 1 case of cure, 1 case of longterm drainage until death of biliary tract bleeding one year later, and 4 cases of lost in followup.ConclusionBronchobiliary fistula is characterized by biliptysis. Minimally invasive treatment should be the first therapeutic option.

参考文献/References:

[1]Peacock TB. Case in which hydatids were expectorated and one of suppuration of a hydatid cyst of the liver communicating with the lungs. Edinburgh Med J, 1850,74:33-46.
[2]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(33):3842-3849.
[3]Crnjac A, Pivec V, Ivanecz A. Thoracobiliary fistulas: literature review and a case report of fistula closure with omentum majus. Radiol Oncol, 2013,47(1):77-85.
[4]AndradeAlegre R, RuizValdes M. Traumatic thoracobiliary (pleurobiliary and bronchobiliary) fistula. Asian Cardiovasc Thorac Ann, 2013,21(1):43-47.
[5]Karabulut N, Cakmak V, Kiter G. Confident diagnosis of bronchobiliary fistula using contrastenhanced magnetic resonance cholangiography. Korean J Radiol, 2010,11(4):493-496.
[6]Mukkada RJ, Antony R, Francis JV, et al. Bronchobiliary fistula treated successfully with endoscopic microcoils and glue. Ann Thorac Surg, 2014,98(2):e33-e34.
[7]Seyyedmajidi M, Kiani M, Javadi H, et al. Hepatobiliary scintigraphy with SPET in the diagnosis of bronchobiliary fistula due to a hydatid cyst. Hell J Nucl Med, 2015,18(2):160-162.
[8]Artunduaga M, Patel NR, Wendt JA, et al. Bronchobiliary fistula localized by cholescintigraphy with singlephoton emission computed tomography. World J Nucl Med, 2015,14(1):60-62.
[9]Kuo YS, Lee SC, Chang H, et al. Thoracoscopic surgery for bronchobiliary fistula: a case report.J Cardiothorac Surg,2014,9:139.
[10]姜中华, 杨红梅, 王正江, 等. 胆道、十二指肠支架置入治疗胆道合并十二指肠恶性梗阻. 中国微创外科杂志, 2014,14(12):1112-1115.
[11]Krige JE, Bornman PC, Beningfield SJ, e al. Endoscopic embolization of external biliary fistulae. Br J Surg, 1990,77(5):581-583.
[12]Jiang K, Su M, Zhang W, et al. Complete radiofrequency ablation of hepatolithiasisassociated cholangiocarcinoma and successful managementof postablation bronchobiliary fistula. Cell Biochem Biophys, 2014,68(3):555-559.
[13]PrietoNieto MI, PérezRobledo JP, AlvarezLuque A, et al. Cutaneous bronchobiliary fistula treated with Tissucol sealant. Cardiovasc Intervent Radiol. 2011,34(Suppl 2):S232-S235.
[14]Shang Y, Bai C, Yao XP, et al. Transnasal flexible bronchoscopic implantation of a nickel titanium (NiTi) bronchial occlusive device for a bronchobiliary fistula. Endoscopy, 2010,42(Suppl 2):E225-E226.
[15]Kostopanagiotou K, George RS, Kefaloyannis E, et al. Novel technique in managing bronchobiliary fistula in adults: Endobronchial embolization using silicone spigots in 2 cases. Ann Thorac Med, 2015,10(1):67-68.
[16]Chandran R, Batra RK, Agarwala S, et al. Selective bronchial blockade with Fogarty catheter in a child with acquired bronchobiliary fistula. Paediatr Anaesth, 2013,23(4):373-375.

备注/Memo

备注/Memo:
﹡通讯作者，Email:lxm2128@163.com
更新日期/Last Update: 2016-03-18