再発性肝細胞癌の無線周波数アブレーションによる気管支孔の外科的治療

気管支虫fist孔（BBF）は、胆管と気管支の木の間に異常な通信がある放射性偏心アブレーション（RFA）のまれな合併症です。非侵襲的介入が失敗した場合にのみ、BBFの手術は考慮されるべきです。このレポートでは、再発性肝細胞癌（HCC）の52歳の女性のRFAの後に遭遇した膿瘍によって複雑になった場合、BBFの外科的管理について説明します。彼女は以前に7年前にHCCの中央二等分切除を受けていたが、手術後に6回目の経口化学拡大と再発HCCの最初のRFAで治療されていた。肝臓の膿瘍とBBFが肝臓の後部で発生した後、彼女は後部断頭切除術と肝ju筋造湿、肺膿瘍の排水、横隔膜切除と修復を受けました。2か月の追跡イメージで胸水と肺の統合が消滅した手術治療を通じて症候性の改善が達成されました。

Bronchobiliary fistula (BBF) is a rare complication of radiofrequency ablation (RFA), in which there is abnormal communications between the biliary tract and the bronchial trees. Surgery should only be considered for BBF when non-invasive interventions have failed. In this report, we describe the surgical management for BBF when complicated by an abscess that was encountered after RFA in a 52-year-old woman with recurrent hepatocellular carcinoma (HCC). She had previously undergone central bisectionectomy of HCC 7 years ago, and had been treated with a sixth transarterial chemoembolization and first RFA for recurrent HCC after the operation. After the liver abscess and BBF occurred in the posterior section of the liver, she received posterior sectionectomy and hepaticojejunostomy, drainage of the lung abscess, diaphragmatic resection and repair because it was impossible to drain the abscess radiologically. Symptomatic improvements were being achieved through operative treatments where pleural effusion and pneumonic consolidation was obliterated on a 2-months follow-up image.