ENDOSCOPIC MANAGEMENT OF BILIOCUTANEOUS FISTULA AFTER PERCUTANEOUS RADIOFREQUENCY ABLATION THERAPY FOR HEPATOCELLULAR CARCINOMA |
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Authors: | Takeshi Tsujino Naoki Sasahira Kenji Hirano Ryosuke Tateishi Hiroyuki Isayama Minoru Tada Shuichiro Shiina Haruhiko Yoshida Takao Kawabe Masao Omata |
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Affiliation: | 1. Departments of Gastroenterology and;2. Endoscopy and Endoscopic Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan |
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Abstract: | Our patient was a 70‐year‐old man with hepatocellular carcinoma (HCC) and liver cirrhosis (Child–Pugh B). He had a history of distal gastrectomy with Billroth II reconstruction for duodenal ulcer and hepatectomy for HCC. One month after percutaneous radiofrequency ablation (RFA) for recurrent HCC, biliocutaneous fistula was observed. The cholangiogram demonstrated leakage of contrast material from an intrahepatic duct into the fistula, and a nasobiliary catheter was placed. Subsequently, the discharge of bile steadily decreased and stopped. Follow‐up cholangiogram revealed no evidence of bile leakage. Biliocutaneous fistula is an extremely rare complication after percutaneous RFA, and the present case report suggests that endoscopic drainage is the first‐line therapy for bile leaks after RFA. |
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Keywords: | biliocutaneous fistula endoscopic biliary drainage radiofrequency ablation |
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