Bronchobiliary Fistula Following Laparoscopic Cholecystectomy
Than Than Aye1, Htun Oo2
Published in Volume 67, No. 4, 2025 October – December issue
https://doi.org/10.64455/xmma0014
Bronchobiliary fistula (BBF) is an abnormal communication between the bronchial system and the biliary tree. This pathological condition may have either congenital or acquired aetiologies. BBF following laparoscopic cholecystectomy (LC) is a rare post-operative complication, with only isolated case reports documented, even in high-volume centres.
A 56-year-old woman presented with an intractable cough and copious expectoration of green-coloured sputum for several weeks. Initially, she was treated by a local practitioner for a presumed respiratory infection. However, her symptoms progressively worsened, accompanied by fever and right upper quadrant abdominal pain, prompting her to seek surgical consultation.
The diagnosis of BBF is often initially suspected based on clinical evaluation. Magnetic resonance cholangiopancreato-graphy (MRCP) with contrast can offer a confident diagnosis, as it clearly delineates contrast leakage from the biliary duct and its communication with the bronchial tree. In our patient, the detailed clinical history and physical examination – including the presence of copious, bitter-tasting, greenish expectorant – strongly pointed to BBF, given that biliptysis is a pathognomonic sign of the condition.
- Professor, Gastroenterology Department, Yangon General hospital, Yangon, Myanmar
- Prof & Head (Retired), Department of Surgery, University Medicine (1) Yangon, Myanmar
Professor, Surgical Division, Bahosi Medical Center, Yangon, Myanmar
Past President, Myanmar Surgical Society
Corresponding author: [email protected]
