Diagnosis and treatment of cholecystoduodenal fistula complicated with gallstone bowel obstruction: a clinical analysis of 16 cases
Author:
Affiliation:

Clc Number:

R657.4

Fund Project:

  • Article
  • |
  • Figures
  • |
  • Metrics
  • |
  • Reference
  • |
  • Related
  • |
  • Cited by
  • |
  • Materials
  • |
  • Comments
    Abstract:

    Objective: To investigate the diagnosis and treatment methods for cholecystoduodenal fistula complicated with gallstone ileus. Methods: The clinical data of 16 patients with cholecystoduodenal fistula and gallstone ileus undergoing surgical treatment from January 2013 to June 2017 were analyzed retrospectively. Results: Of the 16 patients, 8 cases were diagnosed before operation, and 8 cases were diagnosed during operation; 7 cases were diagnosed having concomitant gallstone cholecystitis, and 5 cases were diagnosed having concomitant duodenal ulcer and gastric ulcer before operation. All of the 16 patients underwent surgical treatment, which included small bowel enterotomy and stone extraction plus gastrectomy (Billroth II operation) and Braun’s anastomosis in 7 cases, small bowel enterotomy and stone extraction plus gastrectomy (Billroth II operation) in 3 cases, gastric antrotomy and stone extraction combined with gastrectomy (Billroth II operation) and Braun’s anastomosis in 2 cases, and small bowel enterotomy and stone extraction, cholecystectomy and duodenal fistula repair plus duodenostomy and jejunostomy in 4 cases. The operative average time was 115 min, the average length of hospital stay was 8 d, and liquid food intake started on average postoperative day 9. After the operation, pulmonary infection occurred in 4 cases, duodenal leakage occurred in 2 cases, anastomotic bleeding occurred in 1 case, and wound infection occurred in 3 cases, respectively. All the 16 patients were discharged after a complete cure. Conclusion: Preoperative examinations such as CT and B ultrasound are very important for diagnosis of this condition. For patients with severe inflammatory adhesion of the gallbladder, especially with concomitant duodenal ulcers and gastric ulcers, gastrectomy (Billroth II operation) plus Braun’s anastomosis is effective, while cholecystectomy plus duodenal fistula repair and jejunostomy can be considered for those with mild cholecystitis, and gastric antrotomy and stone removal can be performed in cases with duodenal bulb stone obstruction.

    Reference
    Related
    Cited by
Get Citation

MAO Yuefeng, LUO Henggui, WANG Li. Diagnosis and treatment of cholecystoduodenal fistula complicated with gallstone bowel obstruction: a clinical analysis of 16 cases[J]. Chin J Gen Surg,2018,27(8):1035-1040.
DOI:10.3978/j. issn.1005-6947.2018.08.013

Copy
Share
Article Metrics
  • Abstract:
  • PDF:
  • HTML:
  • Cited by:
History
  • Received:April 29,2018
  • Revised:July 16,2018
  • Adopted:
  • Online: August 15,2018
  • Published: