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A Rare Case of Biliobiliary Fistula
Authors:Hideki SATO  Kazuyuki KANEMASA  Masamichi TANINO  Tsugihiro KIMURA  Kenji MAENOU  Shouji MITSUFUJI  Kyouhei MARUYAMA  Tadashi KODAMA  Kei KASHIMA  Naoki TERAMAE  Susumu FUKUI  Keizo KAGAWA
Abstract:
Abstract: Biliobiliary fistula is a rare clinical entity. The case of a 72 year old female, who presented with epigastric pain and jaundice, is detailed herein. Endoscopic retrograde cholangiopancreatography (ERCP) revealed two stones, one each in the common bile duct and the gallbladder. Continuous endoscopic nasobiliary drainage (ENBD) was performed to relieve obstructive jaundice. Further study with contrast medium administered via the ENBD tube revealed a fistula between the neck of the gallbladder and the common bile duct. The cystic duct was intact. A stone was considered to have migrated into the common bile duct through the fistula. A diagnosis of biliobiliary fistula, Corlette type I was made. However, in this particular case, a biliobiliary fistula was noted at a site below the junction of the cystic duct and common bile duct. Removal of the gallbladder stones was followed by cholecystectomy. The common bile duct was then repaired by utilizing a T-tube. No evidence of malignancy was recognized in the resected gallbladder specimen. In the one year to date since surgery, the patient has been asymptomatic and without signs of biliary disease.
Keywords:biliobiliary fistula  cholelithiasis  ENBD
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