Resumo

MURCIA, Ciro Andrés et al. Thoraco-abdominal approach in bronchobiliary fistula. rev. colomb. cir. [online]. 2017, vol.32, n.3, pp.223-228. ISSN 2011-7582.  https://doi.org/10.30944/20117582.28.

Bronchobiliary fistula is a rare entity in our environment and it is poorly described in the scientific literature. It is characterized by an abnormal communication between the bronchial tree and the biliary tract, and is associated with the presence of bile in the sputum (bilioptysis). According to its etiology, it may be secondary to a distal obstruction of the bile duct due to a benign, malignant, infectious, or iatrogenic pathology. We present the case of a 33-year-old patient who had a bronchobiliary fistula secondary to a percutaneous biliary tract bypass due to a stenotic lesion of the biliary confluent in whom an inferior lobectomy by video-assisted thoracoscopy surgery (VATS) was performed with hepatectomy with biliary tract reconstruction by laparotomy, a combined thoracic and abdominal approach. Given the low incidence of this type of cases and the scarce literature reports, our conclusion is that it is difficult to define the possible etiology of the bile duct stenosis in young patients, and that a malignant pathology cannot be ruled out. Once the diagnosis is established, the cause should be treated. Surgery remains the mainstay of treatment, and with the advent of minimally invasive surgery a combined type of management can be performed so as to take advantage of the benefits of this technology.

Palavras-chave : Biliary fistula; bronchial fistula; bile ducts; common bile duct; cholangiocarcinoma.

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