Therapeutics in hepatobronchial fistula caused by microwave ablation for the treatment of recurrent hepatic carcinoma: A case report.

Hepatobronchial fistula is an uncommon but potentially life-threatening complication that can occurs following microwave ablation for hepatocellular carcinoma. The complication is associated with a significant mortality rate. We report the case of a patient with alcoholic cirrhosis and recurrent hepatic carcinoma who developed a delayed pyogenic liver abscess and hepatobronchial fistula and was treated using an uncommon treatment approach. The abscess in segment VIII, adjacent to the diaphragm, progressed to hepatobronchial fistula due to infection caused by Citrobacter freundii. Despite septic shock, acute liver injury, and delayed abscesses, the patient achieved complete oncologic and infectious resolution through ultrasound-guided percutaneous transhepatic drainage combined with lavage, thereby avoiding the need for high-risk surgery. Overall, the present case report highlights the viability of minimally invasive strategies for treating hepatobronchial fistula. In addition, this report emphasizes the significance of diaphragmatic protection during microwave ablation and the need for individualized treatment for postoperative complications.