The multidisciplinary treatment of bronchobiliary fistula present in a patient with pancreatic neuroendocrine tumor

Abstract

Baris Ozcan, Metin Cevener, Omer Vefik Ozozan, Saim Yilmaz, Alihan Gurkan

Bronchobiliary Fistula (BBF) is a rare condition that usually occurs after surgical treatments of pancreas, liver and biliary diseases. Clinical findings are bilioptysis, fever and dyspnea. In treating it, initially, drainage should be conducted using minimally invasive or endoscopic methods, such as endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTK) in cases where these methods failed. Next, treatment through performing surgical operations, like hepatectomy or pulmonary resection, should be carried out. In this work, the diagnostic and therapeutic phases of a female patient at the age of 40 who underwent a whipple procedure (pancreatoduodenectomy) 10 years earlier because of pancreatic neuroendocrine tumor is presented. Their follow-ups exhibited multiple metastases in the liver, and for this reason, specific chemoembolization treatments were applied. After these treatments, bronchobiliary fistula was formed.