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Case Reports: Rare disease
Laparoscopic management of combined cholecystogastric and cholecystocolonic fistulae
  1. Christina Zhu1,
  2. Ferris Zeitouni1,
  3. Justin Vaughan1,2 and
  4. Ariel P. Santos1,2
  1. 1Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
  2. 2Covenant Medical Center, Lubbock, Texas, USA
  1. Correspondence to Dr Ariel P. Santos; ariel.santos{at}ttuhsc.edu

Abstract

Cholecystogastric and cholecystocolonic fistulae are rare sequelae of longstanding cholelithiasis and can complicate surgical management. Our case involves a male patient in his early 40s with a history of chronic cholelithiasis who presented to the emergency department with severe abdominal pain. Findings on imaging were consistent with acute calculous cholecystitis. During laparoscopic cholecystectomy, the presence of both cholecystogastric and cholecystocolonic fistulae was discovered. Fistula resection with cholecystectomy in a one-step approach using indocyanine green (ICG) angiography was performed. The patient improved and was discharged 3 days later. Laparoscopic management complemented by ICG angiography is a viable surgical approach in patients with cholecystogastric and cholecystocolonic fistulae.

  • Pancreas and biliary tract
  • General surgery

https://doi.org/10.1136/bcr-2023-255951

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    Footnotes

    • Twitter @tinazhu_, @FerrisZeitouni, @justinvaughanMD, @traumamd1

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: CZ, FZ and APS. The following authors gave final approval of the manuscript: APS and JV.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.