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

• Published in: Revista de gastroenterología de México Vol. 82; no. 4; pp. 287 - 295
• Main Authors: Aguilar-Espinosa, F, Maza-Sánchez, R, Vargas-Solís, F, Guerrero-Martínez, G A, Medina-Reyes, J L, Flores-Quiroz, P I
• Format: Journal Article
• Language: English; Spanish
• Published: Mexico 01.10.2017
• Subjects: Aged; Aged, 80 and over; Biliary Fistula - diagnosis; Biliary Fistula - epidemiology; Biliary Fistula - etiology; Biliary Fistula - surgery; Cholecystectomy; Cholelithiasis - complications; Female; Follow-Up Studies; Humans; Incidence; Intestinal Fistula - diagnosis; Intestinal Fistula - epidemiology; Intestinal Fistula - etiology; Intestinal Fistula - surgery; Male; Retrospective Studies; Treatment Outcome; Íleo biliar; Cholecystoduodenal fistula; Gallstone ileus; Fístula colecistoduodenal; Colangitis; Cholangitis
• ISSN: 0375-0906
• DOI: 10.1016/j.rgmx.2016.10.010

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. 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. 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. 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. 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.