Successful Video-Assisted Thoracoscopic Management of Rare Thoracic Complications After Percutaneous Biliary Drainage: A Report of Two Cases

Percutaneous transhepatic gallbladder drainage and percutaneous transhepatic cholangiodrainage are effective therapeutic options for biliary disease, although they occasionally result in thoracic complications. We report two cases of thoracic complications that developed after biliary drainage and were successfully treated using video-assisted thoracoscopic surgery. The first case involved a 55-year-old man who developed a chest wall (extrapleural) abscess after percutaneous transhepatic gallbladder drainage and laparoscopic cholecystectomy. Video-assisted thoracoscopic surgery revealed an extrapleural abscess that was initially diagnosed as empyema. The second case involved a 71-year-old woman who developed bilious pleural effusion after percutaneous transhepatic cholangiodrainage. Video-assisted thoracoscopic surgery was used to identify and close a diaphragmatic fistula. Both patients had a favorable postoperative course. This report demonstrates that video-assisted thoracoscopic surgery can be an effective therapeutic approach for thoracic complications after percutaneous biliary drainage.