Ultrasound-guided PTCL’s successful treatment of bronchobiliary fistula and benign biliary stricture after multiple partial hepatectomy and hepaticojejunostomy: A case report and literature review

Bronchobiliary fistulas (BBFs) are associated with a high mortality and morbidity rate. This article introduces a patient who had coughed up yellowish-green phlegm for two years with a history of multiple previous hepatobiliary surgeries and bronchobiliary fistulas. A preoperative chest CT revealed inflammatory exudation on the dorsal side of the right lower lung, which communicated with the terminal branch of the bronchus. An abdominal CT revealed intrahepatic bile duct dilatation with limited and narrow hilar hepatis, as well as a chaotic and unclear structure. Stones were displayed in the right posterior lobe. Based on the discussions, the patient was decided to perform ultrasound-guided percutaneous transhepatic cholangioscopic lithotony (U-PTCL) to relieve the obstruction and stone problems in the biliary tract. U-PTCL is a minimally invasive procedure. It enables the precise removal of stones, the accurate localization and dilation of the stenotic bile duct segment, and the placement of supportive drainage tubes. After U-PTCL, the patient experienced a reduction in intrahepatic bile duct stones, and the cough significantly improved. During a two-year follow-up, the patient did not complain of discomfort. This article introduces a minimally invasive method-U-PTCL-for solving bronchobiliary fistulas and benign biliary strictures after a multiple partial hepatectomy and hepaticojejunostomy.