Cholecystoduodenocolic Fistula: An Unexpected Intraoperative Finding, a Surgical Challenge

作     者：Gulzar Ahmad Bhat Rahul Jain Pawan Lal Gulzar Ahmad Bhat;Rahul Jain;Pawan Lal

作者机构：Gen. & Minimal Access Surgery Lok Nayak Hospital Maulana Azad Medical College New Delhi India 

出 版 物：《International Journal of Clinical Medicine》 (临床医学国际期刊（英文）)

年 卷 期：2016年第7卷第4期

页      面：261-264页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Fistula Cholecystectomy Cholecystoduodenocolic Fistula 

摘      要：The bilioenteric fistulas, first described in 1890 by Courvoisier, are found in 0.15% - 8% of biliary tract operations. Combined fistulas involving the gallbladder, duodenum and colon are extremely rare. We presented a case of 38 year female who presented to our OPD with complaints of pain right upper abdomen for seven months in whom a cholecysto-duodenocolic fistula (Figure 1 & Figure 2) was found during surgery which was repaired primarily. Gallstone disease is a common problem in hepatobiliary system and may rarely present as cholecysto-enteric fistula. The most common type of biliary enteric fistula is Cholecystoduodenal fistula (70%). Cholecysto-duodeno-colic (CDC) fistula is a rare complication of cholelithiasis. The standard treatment of IBF is cholecystectomy and repair of the fistulous opening. Although very rare a cholecystoduodenocolic fistula should be kept as a possibility when there are adhesions between GB, duodenum and colon. Conversion to open surgery should be considered early when the anatomy is not clear to prevent iatrogenic injury.