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仅用内镜治疗封闭胆囊-胆总管瘘:一例报告。

Cholecystocolic fistula closed using endoscopic therapy alone: A case report.

机构信息

Division of Innovative Medicine for Hepatobiliary and Pancreatology, Faculty of Medicine, Kagawa University, Kagawa, Japan.

Department of Internal Medicine, HITO Medical Center, Ehime, Japan.

出版信息

Medicine (Baltimore). 2022 Jul 22;101(29):e29680. doi: 10.1097/MD.0000000000029680.

Abstract

BACKGROUND

Cholecystocolic fistula (CCF) is a known but rare complication of cholelithiasis. Treatment for CCF is generally surgical. As the number of elderly patients has increased in recent years, many cases require non-surgical treatment; therefore, endoscopic treatment has gained importance.

PATIENT CONCERNS AND DIAGNOSIS

An 87-year-old woman presented with impaired consciousness and symptoms of anorexia. Computed tomography showed cholecystitis and a fistula between the gallbladder and transverse colon. Colonoscopy revealed a CCF. The condition was diagnosed as CCF caused by acute cholecystitis.

INTERVENTIONS AND OUTCOMES

The patient declined surgery due to her age. Endoscopic fistula closure was performed using a through-the-scope clip after endoscopic naso-gallbladder drainage. Successful closure of the fistula resulted in improvement of cholecystitis and anorexia. The patient was discharged after one month. It has been more than 18 months since the procedure, there has been no recurrence.

CONCLUSION

This report on successful endoscopic closure of a CCF indicates that it may be useful for patients who decline surgery.

摘要

背景

胆囊结肠瘘(CCF)是胆石病的一种已知但罕见的并发症。CCF 的治疗通常需要手术。近年来,老年患者的数量不断增加,许多病例需要非手术治疗,因此内镜治疗变得越来越重要。

患者关注和诊断

一名 87 岁女性因意识障碍和食欲不振就诊。计算机断层扫描显示胆囊炎和胆囊与横结肠之间的瘘管。结肠镜检查发现 CCF。诊断为急性胆囊炎引起的 CCF。

干预措施和结果

由于患者年龄较大,她拒绝手术。在进行内镜鼻胆囊引流后,使用经内镜夹闭瘘管。瘘管成功闭合后,胆囊炎和食欲不振得到改善。患者一个月后出院。手术后已经超过 18 个月,没有复发。

结论

本报告成功内镜下闭合 CCF 表明,对于拒绝手术的患者可能是有用的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d05/9302365/9205343b0e13/medi-101-e29680-g001.jpg

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