Stent-graft placement for treatment of massive hemobilia caused by porto-biliary fistula

Abstract

Proton beam therapy is a type of radiation therapy and a promising modality for cancer management because it involves few adverse effects and high therapeutic efficacy. However, there are reports of acute and late complications because of normal tissue damage. Hemobilia, known as bleeding from the biliary tree, is observed in various conditions, and it can also be of iatrogenic origin such as due to percutaneous hepatobiliary interventions. In most cases, it can be managed conservatively without significant hemorrhage. However, in a few cases with massive hemobilia, further intervention is necessary. We report the successful use of a stent-graft in the portal vein to treat massive hemobilia with porto-biliary fistula that was caused by previous proton beam therapy.

Keywords

• biliary fistula; hemobilia; proton therapy; self expandable metallic stents