ENDOSCOPIC (-ERC) FIBRIN SEALING AND HISTOACRYL SEALING OF AN ABSCESSINDUCED BILIO-HEPATICO-CUTANEOUS AND A BILIO-HEPATICO-PHRENICO-BRONCHIAL FISTULOUS SYSTEM

We report the case of a female patient with persisting bilio-bronchial and bilio-cutaneous fistulae originating in the right liver lobe. The causative factor was a subphrenic liver abscess which had been adequa tely and successfully treated. No biliary obstruction was detectable o n admission. Because of her previous medical history the patient was c onsidered to be a high surgical risk. Therefore the described endoscop ic (ERC) approach was chosen. Here we describe the first successful at tempt to close such a fistulous system by repeated fibrin and histoacl yl-sealing through an endoscopically guided catheter. The success of t his innovative procedure may be helpful, in the management of similar cases in the future.