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腹腔镜胆囊切除术中意外发现胆囊十二指肠瘘:一例报告

Accidental discovery of cholecystoduodenal fistula during laparoscopic cholecystectomy: a case report.

作者信息

Huang Rui, Tian Jian-Xing, Deng Xu, Zhu Zong-Long, Tian Wei, Yang Chun-Yuan, Xia Ming, Pan Wei

机构信息

Department of Hepatobiliary and Pancreatic Surgery, The People's Hospital of Lezhi, Lezhi, China.

出版信息

Front Surg. 2025 Aug 13;12:1617555. doi: 10.3389/fsurg.2025.1617555. eCollection 2025.

Abstract

Cholecystoduodenal fistula (CDF) is a rare complication of cholelithiasis. Sometimes, a preoperative examination does not fully detect CDF and may have an impact on the conduct of the surgery. Sometimes, clinicians fail to accurately determine the presence of CDF, which may have an impact on the conduct of the procedure. Here, we report the diagnosis and management of a patient with a CDF that was accidentally detected intraoperatively. The patient was hospitalized twice in our hospital due to excessive inflammation around the gallbladder and combined with choledochal stones. During the second hospitalization, a CDF was accidentally found during laparoscopic cholecystectomy. We repaired the fistula, ligated the cystic duct, and removed the gallbladder laparoscopically while ensuring patient safety. In the absence of preoperative detection of a cholecystoenteric fistula (CEF), intraoperative judgment and postoperative management are of particular importance, which is what will be discussed in this article.

摘要

胆囊十二指肠瘘(CDF)是胆石症的一种罕见并发症。有时,术前检查无法完全检测出CDF,可能会影响手术的进行。有时,临床医生无法准确判断CDF的存在,这可能会影响手术操作。在此,我们报告一例术中意外发现的CDF患者的诊断和治疗情况。该患者因胆囊周围炎症过重并合并胆总管结石,在我院住院两次。第二次住院期间,在腹腔镜胆囊切除术过程中意外发现了CDF。我们修复了瘘管,结扎了胆囊管,并在确保患者安全的同时,腹腔镜下切除了胆囊。在术前未检测出胆囊肠瘘(CEF)的情况下,术中判断和术后管理尤为重要,本文将对此进行讨论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9aa9/12392628/7654b5b2d15d/fsurg-12-1617555-g001.jpg

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