Thoracoscopic approach of a complicated pleuro-biliary fistula, after a right hepatectomy
INTRODUCTION: Pleuro-biliary fistula is a rare complication that originates from various causes, including liver resections. There is no consensus on how to manage them. There are 2 types of treatment: surgical and conservative. Both can be combined. The latter involves the combination of minor surg...
| Autores principales: | , , , |
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2020
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| Materias: | |
| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/28445 |
| Aporte de: |
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I10-R327-article-28445 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
biliary fistula empyema hepatectomy thoracoscopy fistula biliar empiema hepatectomia toracoscopía fistula biliar empiema hepatectomia toracoscopia |
| spellingShingle |
biliary fistula empyema hepatectomy thoracoscopy fistula biliar empiema hepatectomia toracoscopía fistula biliar empiema hepatectomia toracoscopia Sastre, Ignacio España, Manuel Ceballos, Roberto Bustos, Mario Eduardo Francisco Thoracoscopic approach of a complicated pleuro-biliary fistula, after a right hepatectomy |
| topic_facet |
biliary fistula empyema hepatectomy thoracoscopy fistula biliar empiema hepatectomia toracoscopía fistula biliar empiema hepatectomia toracoscopia |
| author |
Sastre, Ignacio España, Manuel Ceballos, Roberto Bustos, Mario Eduardo Francisco |
| author_facet |
Sastre, Ignacio España, Manuel Ceballos, Roberto Bustos, Mario Eduardo Francisco |
| author_sort |
Sastre, Ignacio |
| title |
Thoracoscopic approach of a complicated pleuro-biliary fistula, after a right hepatectomy |
| title_short |
Thoracoscopic approach of a complicated pleuro-biliary fistula, after a right hepatectomy |
| title_full |
Thoracoscopic approach of a complicated pleuro-biliary fistula, after a right hepatectomy |
| title_fullStr |
Thoracoscopic approach of a complicated pleuro-biliary fistula, after a right hepatectomy |
| title_full_unstemmed |
Thoracoscopic approach of a complicated pleuro-biliary fistula, after a right hepatectomy |
| title_sort |
thoracoscopic approach of a complicated pleuro-biliary fistula, after a right hepatectomy |
| description |
INTRODUCTION: Pleuro-biliary fistula is a rare complication that originates from various causes, including liver resections. There is no consensus on how to manage them. There are 2 types of treatment: surgical and conservative. Both can be combined. The latter involves the combination of minor surgical procedures such as pleural drainage placement, image-guided percutaneous procedures, and endoscopic procedures. Surgical treatment includes more aggressive approaches such as thoracotomy and / or laparotomy, and can be performed at the start of fistula management or in the event of failure of conservative treatment. In these cases open thoracotomy is the most used approach according to the literature.
METHOD: We present the case of a patient undergoing a postoperative right hepatectomy for hepatoarcinoma that complicates with an external biliary fistula and then with a pleuro-biliary fistula with empyema, in which thoracoscopy is used as part of the treatment.
RESULT: the patient resolved the complication and the pleural drainage was removed 7 days later.
CONCLUSION: thoracoscopy is a safe and effective approach in the treatment of this complication. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2020 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/28445 |
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I10-R327-article-284452024-08-27T18:28:15Z Thoracoscopic approach of a complicated pleuro-biliary fistula, after a right hepatectomy Abordaje toracoscópico de fístula bilio-pleural complicada, post hepatectomía derecha Abordagem toracoscópica de uma fístula bilio-pleural complicada, pós-hepatectomia direita Sastre, Ignacio España, Manuel Ceballos, Roberto Bustos, Mario Eduardo Francisco biliary fistula empyema hepatectomy thoracoscopy fistula biliar empiema hepatectomia toracoscopía fistula biliar empiema hepatectomia toracoscopia INTRODUCTION: Pleuro-biliary fistula is a rare complication that originates from various causes, including liver resections. There is no consensus on how to manage them. There are 2 types of treatment: surgical and conservative. Both can be combined. The latter involves the combination of minor surgical procedures such as pleural drainage placement, image-guided percutaneous procedures, and endoscopic procedures. Surgical treatment includes more aggressive approaches such as thoracotomy and / or laparotomy, and can be performed at the start of fistula management or in the event of failure of conservative treatment. In these cases open thoracotomy is the most used approach according to the literature. METHOD: We present the case of a patient undergoing a postoperative right hepatectomy for hepatoarcinoma that complicates with an external biliary fistula and then with a pleuro-biliary fistula with empyema, in which thoracoscopy is used as part of the treatment. RESULT: the patient resolved the complication and the pleural drainage was removed 7 days later. CONCLUSION: thoracoscopy is a safe and effective approach in the treatment of this complication. INTRODUCCION: La fístula biliopleural es una complicación poco frecuente que se origina por diversas causas, entre ellas, las resecciones hepáticas. No existe consenso acerca de cómo manejarlas. Existe 2 tipos de tratamiento: el quirúrgico y el conservador. Ambos pueden combinarse. El último implica la utilizacion de procedimientos quirúrgicos menores tales como la colocación de un tubo de drenaje pleural, drenajes percutáneos bajo guía imagenológica y procedimientos endoscópicos. El tratamiento quirúrgico incluye abordajes más agresivos como la toracotomía y/o laparotomía, y puede realizarce al inicio del manejo de la fístula o ante la falla del tratamiento conservador. En estos casos la toracotomia abierta es el abordaje más utilizado según la literatura, sin mencionar a la videotoracoscopia. METODO: Presentamos el caso de un paciente cursando un posoperatorio de hepatectomía derecha por hepatoarcinoma que complica con una fístula biliar externa y luego con una fístula biliopleural complicada con empiema, en el cual se utiliza la toracoscopía como parte del tratamiento. RESULTADO: el paciente resolvio la complicacion y se extrajo el drenaje pleural 7 dias despues. CONCLUSION: la toracoscopía es un abordaje seguro y efectivo en el tratamiento de esta complicacion. INTRODUÇÃO: A fístula biliopleural é uma complicação rara que se origina de várias causas, incluindo ressecções hepáticas. Não há consenso sobre como gerenciá-los. Existem 2 tipos de tratamento: cirúrgico e conservador. Ambos podem ser combinados. O último envolve o uso de procedimentos cirúrgicos menores, como a colocação de um tubo de drenagem pleural, procedimentos percutâneos guiados por imagem e procedimentos endoscópicos. O tratamento cirúrgico inclui abordagens mais agressivas, como toracotomia e / ou laparotomia, e pode ser realizado no início do manejo da fístula ou no caso de falha do tratamento conservador. Nestes casos, a toracotomia aberta é a abordagem mais utilizada de acordo com a literatura, e o uso da videotoracoscopia não é mencionado. MÉTODO: Apresentamos o caso de um paciente submetido a hepatectomia direita pós-operatória de hepatoarcinoma que complica com uma fístula biliar externa e, em seguida, com uma fístula biliopleural com empiema, na qual a toracoscopia é usada como parte do tratamento. RESULTADO: o paciente resolveu a complicação e a drenagem pleural foi removida 7 dias depois. CONCLUSÃO: a toracoscopia é uma abordagem segura e eficaz no tratamento dessa complicação. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020-08-21 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/28445 10.31053/1853.0605.v77.n3.28445 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 77 No. 3 (2020); 199-202 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 77 Núm. 3 (2020); 199-202 Revista da Faculdade de Ciências Médicas de Córdoba; v. 77 n. 3 (2020); 199-202 1853-0605 0014-6722 10.31053/1853.0605.v77.n3 spa https://revistas.unc.edu.ar/index.php/med/article/view/28445/30364 https://revistas.unc.edu.ar/index.php/med/article/view/28445/31183 Derechos de autor 2020 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |