# Successful Bronchial Occlusion With an Endobronchial Watanabe Spigot Using a Single‐Use Bronchoscope for Bronchobiliary Fistula: A Case Report

## TL;DR

A rare case of bronchobiliary fistula was successfully diagnosed and treated using a single-use bronchoscope at the bedside in a critically ill patient.

## Contribution

This is the first reported use of a single-use bronchoscope for bronchial occlusion in a bronchobiliary fistula.

## Key findings

- A 62-year-old male with a bronchobiliary fistula was diagnosed and treated at the bedside using a single-use bronchoscope.
- The patient was successfully extubated and discharged without recurrence of the fistula.
- Single-use bronchoscopes may be a viable alternative in critically ill patients where transport is challenging.

## Abstract

Bronchobiliary fistula (BBF) is a rare condition characterised by a pathological communication between the biliary tract and bronchial tree secondary to various diseases. Treatment includes bronchial occlusion using reusable bronchoscopes, although the use of single‐use bronchoscopes (SUBs) for this purpose has not been reported. This case report describes a 62‐year‐old male who developed a BBF after anterior hepatic segmentectomy for hepatocellular carcinoma. The patient was admitted to the intensive care unit for severe pneumonia and respiratory failure. Bedside bronchoscopy using SUBs revealed bile leakage from the right B7 bronchus, leading to the diagnosis of BBF. Due to his critical condition and transport difficulties, bronchial occlusion was successfully performed at bedside using an SUB. The patient was extubated on day 12 and discharged on day 25 without recurrence. This case highlights the utility of SUBs for diagnostic and therapeutic intervention in critically ill patients.

A rare case of bronchobiliary fistula after liver resection was successfully diagnosed and treated with bronchial occlusion at bedside using a single‐use bronchoscope. The use of single‐use bronchoscopes may be viable in critically ill patients, especially when the use of a reusable bronchoscope is not feasible.