Biliary-colonic fistula : A case report and literature review

We report the occurrence of common bile duct obstruction and biliary-colonic fistula after open cholecystectomy. Although it is a very unusual complication after cholecystectomy, biliary-colonic fistula should be part of the differential diagnosis for patients presenting with sepsis after open or la...

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Bibliographic Details
Published in:The American surgeon 2006-04, Vol.72 (4), p.347-350
Main Authors: MUNENE, Gitonga, GRAHAM, Jay A, HOLT, Richard W, JOHNSON, Lynt B, MARSHALL, Harry P
Format: Article
Language:English
Subjects:
Abdomen
Antibiotics
Bile
Biliary Fistula - diagnosis
Biliary Fistula - etiology
Biliary Fistula - surgery
Biological and medical sciences
Case studies
Cholecystectomy - adverse effects
Cholelithiasis - surgery
Colonic Diseases - diagnosis
Colonic Diseases - etiology
Colonic Diseases - surgery
Diagnostic tests
Female
Gallbladder
Gallbladder diseases
Gallstones
General aspects
Humans
Iatrogenic Disease
Intestinal Fistula - diagnosis
Intestinal Fistula - etiology
Intestinal Fistula - surgery
Literature reviews
Medical sciences
Middle Aged
Patients
Physical examinations
Surgery
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Summary:We report the occurrence of common bile duct obstruction and biliary-colonic fistula after open cholecystectomy. Although it is a very unusual complication after cholecystectomy, biliary-colonic fistula should be part of the differential diagnosis for patients presenting with sepsis after open or laparoscopic cholecystectomy. After confirmation and characterization of the injury by endoscopic retrograde cholangiopancreatography and cholangiogram, assessment for undrained collections by computed tomography scan, control of sepsis and coagulopathy, and nutritional support, surgical repair was undertaken. The patient underwent fistula take-down between the common bile duct and the colon at the hepatic flexure, primary closure of the colon enterotomy, and a Roux-en-Y end-to-side hepaticojejunostomy at the confluence of the right and left hepatic ducts. Recovery was uneventful and the patient was doing well at the 6-month follow-up. Surgical repair should be undertaken by surgeons with extensive experience in hepatobiliary reconstruction.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313480607200415