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Rev Gastroenterol Mex. 2017 Oct - Dec;82(4):287-295. doi: 10.1016/j.rgmx.2016.10.010. Epub 2017 Apr 5.

Cholecystoduodenal fistula, an infrequent complication of cholelithiasis: Our experience in its surgical management.

[Article in English, Spanish]

Author information

1
Servicio de Cirugía General, Hospital Regional Puebla, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Puebla, Puebla, México. Electronic address: francisco_fae@msn.com.
2
Servicio de Cirugía General, Hospital Regional Puebla, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Puebla, Puebla, México.

Abstract

INTRODUCTION:

Bilioenteric fistulas are the abnormal communication between the bile duct system and the gastrointestinal tract that occurs spontaneously and is a rare complication of an untreated gallstone in the majority of cases. These fistulas can cause diverse clinical consequences and in some cases be life-threatening to the patient.

AIM:

To identify the incidence of bilioenteric fistula in patients with gallstones, its clinical presentation, diagnosis through imaging study, surgical management, postoperative complications, and follow-up.

MATERIALS AND METHODS:

A retrospective study was conducted to search for bilioenteric fistula in patients that underwent cholecystectomy at our hospital center due to cholelithiasis, cholecystitis, or cholangitis, within a 3-year time frame.

RESULTS:

Four patients, 2 men and 2 women, were identified with cholecystoduodenal fistula. Their mean age was 81.5 years. Two of the patients presented with acute cholangitis and 2 presented with bowel obstruction due to gallstone ileus. All the patients underwent surgical treatment and the diagnostic and therapeutic management of each of them was analyzed.

CONCLUSIONS:

The incidence of cholecystoduodenal fistula was similar to that reported in the medical literature. It is a rare complication of gallstones and its diagnosis is difficult due to its nonspecific symptomatology. It should be contemplated in elderly patients that have a contracted gallbladder with numerous adhesions.

KEYWORDS:

Cholangitis; Cholecystoduodenal fistula; Colangitis; Fístula colecistoduodenal; Gallstone ileus; Íleo biliar

PMID:
28389051
DOI:
10.1016/j.rgmx.2016.10.010
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