Shioi Yoshihiro, Kawamura Shuji, Kanno Kiminori, Nishinari Yutaka, Ikeda Kousei, Noro Akihiro, Kooka Fumishi
Department of Surgery, Iwate Prefectural Esashi Hospital, 5-23 Nishiodori, Esashi, Oshu, Iwate 023-1103, Japan.
Int J Surg Case Rep. 2012;3(1):12-5. doi: 10.1016/j.ijscr.2011.07.012. Epub 2011 Oct 14.
Gallstone ileus, a rare complication of cholelithiasis and cholecystitis, is a relatively rare cause of alimentary tract obstruction. It is usually associated with a cholecystoenteric fistula through which a gallstone has passed into the gastrointestinal tract. Cholecystoenteric fistula uncommonly closes spontaneously, the period between formation and closure having rarely been reported. In addition, endoscopic detection of cholecystoenteric fistulous closure has seldom been reported.
We report a 51-year-old Japanese man with gallstone ileus in whom spontaneous closure of a cholecystoduodenal fistula was observed by endoscopy 2 weeks after laparoscopy-assisted enterolithotomy.
Laparoscopy-assisted enterolithotomy for gallstone ileus allows direct diagnosis of gallstone ileus and assessment of the status of adhesions affecting the biliary tract.
Endoscopic confirmation of fistulous closure after laparoscopy-assisted enterolithotomy is a minimally invasive approach that may avert the need for biliary surgery.
胆石性肠梗阻是胆石症和胆囊炎的一种罕见并发症，是消化道梗阻相对少见的原因。它通常与胆囊肠瘘相关，胆石通过该瘘进入胃肠道。胆囊肠瘘很少自发闭合，形成与闭合之间的时间段鲜有报道。此外，内镜检测到胆囊肠瘘闭合的情况也很少被报道。
我们报告一名51岁的日本男性患有胆石性肠梗阻，在腹腔镜辅助肠石切除术2周后通过内镜观察到胆囊十二指肠瘘自发闭合。
腹腔镜辅助肠石切除术治疗胆石性肠梗阻可直接诊断胆石性肠梗阻，并评估影响胆道的粘连情况。
腹腔镜辅助肠石切除术后通过内镜确认瘘闭合是一种微创方法，可能避免胆道手术的需要。
