Biliary-Caval Fistula following Y90 Radioembolization

Area of Science:

• Interventional Radiology
• Hepatobiliary Surgery
• Oncology

Background:

• Radioembolization with yttrium-90 (90Y) is a widely used treatment for liver malignancies.
• While major complications are rare, biliary complications have been noted, particularly in patients with prior biliary interventions.
• These complications include bile duct injury and hepatic abscess formation.

Purpose of the Study:

• To review a case of recurrent cholangitis, sepsis, and biliary-caval fistula following 90Y radioembolization.
• To examine current data on biliary complications after 90Y radioembolization in patients with a history of biliary surgery or interventions.

Main Methods:

• Case report review.
• Literature search for studies on 90Y radioembolization and biliary complications.
• Analysis of patient history and treatment outcomes.

Main Results:

• The reviewed case presented with severe biliary complications, including cholangitis, sepsis, and a biliary-caval fistula post-90Y radioembolization.
• Existing literature indicates an elevated risk of biliary complications in patients with prior biliary surgery or interventions.

Conclusions:

• Patients with a history of biliary surgery or interventions represent a higher-risk group for biliary complications after 90Y radioembolization.
• Careful patient selection and consideration of prior biliary interventions are crucial when planning 90Y radioembolization.
• Further research is needed to optimize management strategies for this patient subgroup.