Ann Surg Treat Res.  2014 Nov;87(5):276-278. 10.4174/astr.2014.87.5.276.

Incidental cholecystojejunal fistula treated with successful laparoscopic management

• Jung HI
• Ahn T
• Cho SW
• Bae SH
• Lee MS
• Kim CH

• KMID: 2266888
• DOI: http://doi.org/10.4174/astr.2014.87.5.276

Abstract

Internal biliary fistula (IBF) is occurred spontaneously due to the biliary disease in most cases. Bilioenteric, biliobiliary, bronchobiliary, and vasculobiliary type of IBF have been reported in the literature. We herein describe our experience with an incidental cholecystojejunal fistula, a very rare type of bilioenteric fistula in laparoscopic cholecystectomy. A 61-year-old woman with several years' history of intermittent right upper abdominal pain was admitted to Soonchunhyang University Cheonan Hospital. Abdominal CT scan showed the pneumobilia in gallbladder with common bile duct dilatation. Endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy were done. On operative findings, there was a cholecystojejunal fistula. We performed laparoscopic cholecystectomy and fistulectomy with jejunal partial resection. To our knowledge, this is the first report on incidental cholecystojejunal fistula uncombined with any other disease and was treated with laparoscopic procedure.

Keyword

Cholecystojejunal fistula; Biliary fistula; Gallbladder

MeSH Terms

Abdominal Pain
Biliary Fistula
Cholangiopancreatography, Endoscopic Retrograde
Cholecystectomy, Laparoscopic
Chungcheongnam-do
Common Bile Duct
Dilatation
Female
Fistula*
Gallbladder
Humans
Middle Aged
Sphincterotomy, Endoscopic
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 (A) The CT scan shows minimal wall enhancement and pneumobilia in gallbladder (white arrow). (B) The gallbladder and the small bowel are adherent with each other (white arrow). (C) Panel C also shows peumobilia in gallbladder (white arrow).

• 

  Fig. 2 (A) Magnetic resonance cholangiopancreatography also shows pneumobilia in gallbladder (white arrows). (B) Small bowel and fundus of gallbladder connected to each other (white arrows).

• 

  Fig. 3 Magnetic resonance cholangiopancreatography shows the enhancement lesion which is suspected as the small bowel (black arrow).

Reference

1. Shah M, Mori W. A clinico-pathological study of spontaneous internal biliary fistula. Acta Pathol Jpn. 1973; 23:349–358.

2. Duzgun AP, Ozmen MM, Ozer MV, Coskun F. Internal biliary fistula due to cholelithiasis: a single-centre experience. World J Gastroenterol. 2007; 13:4606–4609.

3. Fumimoto Y. A case of cholecystojejunal fistula treated with laparoscopic surgery. J Nissei Hosp. 2001; 29:180–185.

4. Angrisani L, Corcione F, Tartaglia A, Tricarico A, Rendano F, Vincenti R, et al. Cholecystoenteric fistula (CF) is not a contraindication for laparoscopic surgery. Surg Endosc. 2001; 15:1038–1041.

5. Martin I, Siriwardena A. Safe laparoscopic cholecystectomy in the presence of a cholecysto-enteric fistula. Dig Surg. 2000; 17:178–180.