Biliary and Gastrointestinal Fistulas
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Abstract
Abstract
A 76-year-old woman presented with a deterioration in her general condition, abdominal pain, and vomiting.Elevated inflammatory markers prompted abdominal CT, which revealed small bowel obstruction due to gallstone ileus, aerobilia, and a cholecystoduodenal fistula (Fig. 1). Initial Surgical Management:The patient underwent emergency laparoscopic-assisted small bowel resection of the ileum, with stone extraction and end-to-end anastomosis.The postoperative course was complicated by acute kidney injury requiring temporary dialysis and aspiration pneumonia.After stabilization, the patient was referred for endoscopic evaluation.First Endoscopic Phase (4 weeks postoperatively): Gastroscopy confirmed the CDF.Several gallstones were extracted endoscopically through the fistula tract.Subsequent ERCP was performed, and two plastic stents were placed in the common bile duct (CBD) to ensure decompression.Follow-up gastroscopy 1 week later showed a benign appearance of the fistula site; therefore, the stents were removed, and active closure was deferred (Fig. 2).
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@article{Khalil2026Endoscopic,
title = {Endoscopic Management of Cholecystoduodenal Fistula: A Tale of Two Techniques—Staged OTSC Closure vs. Spontaneous Healing},
author = {Ahmed Khalil and Mahmoud Zarefa and T. Plusczyk},
journal = {Diagnostic and Interventional Endoscopy},
year = {2026},
doi = {10.14744/diagnintervendosc.2026.0102},
url = {https://doi.org/10.14744/diagnintervendosc.2026.0102}
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