Minimally Invasive Treatment of a Bronchobiliary Fistula that Developed Secondary to Chemotherapy-induced Stricturing

A bronchobiliary fistula (BBF) is a rare abnormal communication between the biliary tree and bronchial system. The majority of cases are the result of biliary obstruction or injury, with the major symptomatology of cough and biliptysis. The initial management of BBFs is variable but aims to decompress the biliary system allowing for diversion and passive healing of the fistula tract. Definitive management is with surgical fistulectomy. New minimally invasive therapeutic approaches utilizing endoscopic or percutaneous methodology have been described with some success. We present the successful treatment of a BBF that developed secondary to chemotherapy-induced biliary stricturing (CIBS) with a novel percutaneous embolization approach using a vascular plug and liquid embolic agent.