Successful occlusion of a bronchobiliary fistula using percutaneous microwave ablation: a case report

TL;DR

This case report describes the first successful use of microwave ablation to treat a rare bronchobiliary fistula in a cancer patient.

Contribution

The paper presents the first reported case of BBF successfully treated with percutaneous microwave ablation.

Findings

Percutaneous microwave ablation under CT guidance successfully closed a bronchobiliary fistula in a 35-year-old female.

Symptoms resolved completely after the procedure, with no recurrence observed.

PMWA is proposed as a minimally invasive alternative to traditional surgical or endoscopic approaches.

Abstract

Bronchobiliary fistula (BBF) is an exceptionally rare and complex clinical entity that involves abnormal communication between the biliary system and the bronchial tree. This article presents the first reported case of BBF successfully occluded with percutaneous microwave ablation (PMWA). A 35-years-old female with primary colon cancer developed BBF after PMWA for liver metastasis and presented with bilioptysis that persisted despite conventional antibiotic therapy and drainage. Under computed tomography (CT) guidance, targeted PMWA with an ablation power of 40 w was applied to the fistula tract for 7 min, resulting in complete radiographic closure and resolution of symptoms. Compared with traditional surgical, endoscopic, or drainage-based approaches, PMWA represents a minimally invasive alternative. While this technique has significant advantages in terms of precision, quick recovery, and applicability to high-risk patients, its efficacy may be limited in patients with large or anatomically complex fistulas. Further clinical validation is needed to establish long-term outcomes and refine technical parameters. This case supports PMWA as a promising therapeutic option for BBF and highlights its potential in fistula management.

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