{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T02:02:46Z","timestamp":1780020166051,"version":"3.53.1"},"reference-count":23,"publisher":"Baishideng Publishing Group Inc.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Transplant"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n                  <jats:p>Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare malignancy that may lead to complex postoperative complications, including brochobiliary fistula (BBF).<\/jats:p>\n                  <jats:p>CASE SUMMARY<\/jats:p>\n                  <jats:p>We report a 21-year-old patient with pulmonary metastatic FL-HCC, previously treated with multiple liver ablations, left lung wedge resections, and thoracic radiation, who subsequently developed a right-sided BBF. The patient presented for living donor liver transplantation after persistent bilioptysis and recurrent infections despite biliary drainage and prior surgical repair. Intraoperative management was challenging. A left-sided double-lumen tube was used to isolate the left lung and avoid positive-pressure ventilation of the fistulized right lung. However, one-lung ventilation resulted in hypoxia requiring return to two-lung ventilation with continuous suctioning. Surgical dissection was prolonged due to dense adhesions between the liver, right hemidiaphragm, and lung, causing major blood loss and necessitating rapid, high-volume transfusion of blood products.<\/jats:p>\n                  <jats:p>CONCLUSION<\/jats:p>\n                  <jats:p>This case underscores the significant airway, ventilation, and hemorrhage challenges encountered during liver transplantation in patients with persistent BBF and extensive thoracoabdominal adhesions.<\/jats:p>","DOI":"10.5500\/wjt.v16.i2.117975","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T01:19:11Z","timestamp":1780017551000},"source":"Crossref","is-referenced-by-count":0,"title":["Bronchobiliary fistula in fibrolamellar hepatocellular carcinoma with anesthetic challenges during living donor liver transplantation: A case report"],"prefix":"10.5500","volume":"16","author":[{"given":"Andrea","family":"Gomez-Sanchez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibtesam A","family":"Hilmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher B","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dahye","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i33.3842"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1186\/1749-8090-2-52"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2007.01435.x"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25970"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19800715)46:2<372::aid-cncr2820460227>3.0.co;2-s"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1177\/2050640613501507"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1038\/s41698-023-00371-2"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-016-3216-x"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-023-05621-z"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-025-03366-x"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2008.08.029"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1213\/XAA.0000000000000390"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.47176\/mjiri.38.66"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015694"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.04.055"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-198508000-00014"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i25.8072"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2024.107911"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-020-01376-4"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1148\/rg.244035160"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.12.026"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17600"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/BF03027720"}],"container-title":["World Journal of Transplantation"],"original-title":[],"link":[{"URL":"https:\/\/www.wjgnet.com\/2220-3230\/full\/v16\/i2\/117975.htm","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.wjgnet.com\/2220-3230\/full\/v16\/i2\/117975.htm","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T01:19:44Z","timestamp":1780017584000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.wjgnet.com\/2220-3230\/full\/v16\/i2\/117975.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,18]]},"references-count":23,"journal-issue":{"issue":"2"},"alternative-id":["117975"],"URL":"https:\/\/doi.org\/10.5500\/wjt.v16.i2.117975","relation":{},"ISSN":["2220-3230"],"issn-type":[{"value":"2220-3230","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,18]]}}}