A CASE OF CHOLECYSTOLITHIASIS WITH HEPATIC CHOLECYSTODUODENAL FISTULA

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  • 肝管胆嚢十二指腸瘻を伴った胆石症の1例

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Abstract

A rare case of cholecystolithiasis causing hepatic cholecystoduodenal fistula is presented.<br> A 61-year-old woman, who had been pointed out having cholecystolithiasis 3 years before but left it alone because it was asymptomatic, was seen at the hospital because of right hypochondralgia which was recently felt sometimes. No impaired liver function was revealed by laboratory tests, but a ultrasonography showed cholecystolithiasis and a dilatation of the intrahepatic bile duct. On ERC, the hepatic side bile duct including the confluence of three ducts did not visualized. PTC revealed an interruption of the hepatic duct at the porta hepatis and fistulization toward the duodenum was confirmed. Endoscopic examination disclosed that the fistula opened at oral side of the descending part of duodenum. With the diagnosis of hepatic cholecystoduodenal fistula due to cholecystolithiasis, a cholecystectomy and an excision of the bile duct associated with closure by suture of the duodenal fistula were performed on June 9, 1997.

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