Laparoscopic treatment of cholecystoduodenal fistulae

The authors present the cases of laparoscopic treatment of cholecystoduodenal fistulae in our hospital. In a series of 1500 laparoscopic cholecystectomies we encountered five cholecystoduodenal fistulae. One patient underwent a laparotomy, because of the large bile duct stone which could not be extracted laparoscopically. The other four patients underwent laparoscopic repair of cholecystoduodenal fistula. All were females who were 67 years old on avarage. In two patients a cholecystectomy was first completed, followed by repair of fistula with endo GIA stapling device. In the other two the fistulae were transected prior to cholecystectomy. The operation time averaged on hour. There were no complications. All patients were discharged on the fifth postoperative day and returned to normal activities within eight days of surgery. We submin that cholecystoduodenal fistula do not preclude a laparoscopic procedure. We demonstrate two approaches to the repair and in a case of unclear anatomy or other difficulties there is always the possibility of conversion.