Laparoscopic management of cholecystocolonic fistula: A case report and a brief literature review

• Published in: International journal of surgery case reports 2020-01, Vol.68, p.218-220
• Main Authors: Bonventre, G., Di Buono, G., Buscemi, S., Romano, G., Agrusa, A.
• Format: Article
• Language: English
• Subjects: Cholecystocolonic fistula; Complicated cholelithiasis; Laparoscopy
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2020.02.052

•Cholecystoenteric fistula is a rare and late complication of cholelithiasis.•We report a case of cholecysto-colonic fistula with hepatic flexure management by laparoscopic approach, a 64 years old male patients with fever of an unknown origins for two months and abdominal pain.•We performed laparoscopic cholecystectomy and repaired colonic wall with intra-corporeal sutures.•The laparoscopic management of cholecystoeneteric fistula is a feasible and safe procedure but the operative strategy should be individualized. Cholecystoenteric fistula is a rare and late complication of cholelithiasis. The clinical presentation is mostly chronic and is not distinguishable from the dyspeptic symptoms of non-complicated cholelithiasis. For this reason, the preoperative diagnosis is difficult and uncertain, and it is often made up primarily intraoperatively and incidentally during cholecystectomy. In this article, we report a case of cholecystocolonic fistula management by laparoscopic approach. We studied a 64 years old male patient with fever of an unknown origin for two months and abdominal pain. He underwent a contrast enhanced CT abdominal scan that showed a sclerotic gallbladder with a disorganized fluid collection. The colonoscopy identified a cholecystocolonic fistula with hepatic flexure. A laparoscopic cholecystectomy was performed to repair the colonic wall with intra-corporeal sutures. Thanks to the advancements in CT scan’s resolution and the application of endoscopic technology such as ERCP or colonscopy, preoperative diagnosis of cholecystoenteric fistula has been greatly improved. In addition, cholecystoenteric fistula has been successfully managed laparoscopically with laparoscopic cholecystectomy and closure of the fistula tract. The laparoscopic management of cholecystoeneteric fistula is a feasible and safe procedure but the operative strategy should be individualized on diagnosis, patient characteristics, availability of resources and experience of surgical team.