Bronchobiliary Fistulas

A bronchobiliary fistula (BBF) is a rare condition that occurs from an abnormal communication between the biliary tree and bronchial airway. Historically, BBFs resulted as complications from certain traumas, malignancy, or infection; however, iatrogenic etiology is becoming more common in the setting of advancing therapeutics. We present two such cases of patients with bronchobiliary fistulas and subsequent treatment that arose after medical treatment for underlying malignancies. Due to there being no current guidelines on the treatment approach for bronchobiliary fistulas, a literature review spanning over forty years was performed to identify treatment modalities and etiologies documented in the past. The review showed that regardless of the underlying cause of the BBF, a dual therapy approach or multi-modal therapy approach had a higher rate of success than a single intervention approach.