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      Cirugía de emergencia por colecistitis aguda debido a fístula colecistocolónica Translated title: Emergency surgery for acute cholecystitis caused by cholecystocolonic fistula

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          Abstract

          RESUMEN La fístula colecistocolónica (FCC) es una complicación poco común de la colelitiasis. A menudo son asintomáticas, de difícil diagnóstico preoperatorio a pesar del apoyo radiológico, y se descubren de manera incidental perioperatoriamente. Presentamos el caso de una mujer con un cuadro de colecistitis aguda, la cual fue intervenida por laparoscopía, y se evidenció una FCC, la cual fue resuelta mediante conversión a cirugía abierta. La FCC puede complicarse y simular cuadros abdominales agudos. Se debe tener en cuenta en adultos mayores, con historia de colelitiasis, y vesículas escleroatróficas con adherencias. En la literatura se han descrito muy pocos casos, y ninguno en nuestro medio. Presentamos un caso de FCC que ingresó como una colecistitis aguda, y su diagnóstico y tratamiento fueron durante su cirugía.

          Translated abstract

          ABSTRACT Cholecystocolonic fistula (CCF) is a rare complication of cholelithiasis. They are often asymptomatic, difficult to diagnose preoperatively, it despite radiological support, and they are discovered incidentally perioperatively. We present the case of a woman with acute cholecystitis, who was operated by laparoscopy, and a CCF was evidenced, it was resolved by conversion to open surgery. FCC can be complicated and simulate acute abdominal symptoms. It should be taken into account in older adults with a history of cholelithiasis and scleroatrophic vesicles with adhesions. Very few cases have been described in the literature, and none in our country. We present a case of FCC that was admitted as acute cholecystitis, and the diagnosis and treatment of it were during her surgery.

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          Laparoscopic management of cholecystoenteric fistula: A single-center experience

          Aim To report our experience regarding management of cholecystoenteric fistula (CEF) and identify the most effective diagnostic methods and surgical treatment. Methods In total, 10,588 patients underwent laparoscopic cholecystectomy for cholecystolithiasis from January 2000 to December 2014 at the Research Institute of General Surgery, Jinling Hospital (Nanjing, China). Twenty-nine patients were diagnosed with CEF preoperatively or intraoperatively. Data were retrospectively collected on demographics, preoperative diagnostics, intraoperative findings, laparoscopic procedures, complications, and follow-up. Results Twenty-nine patients (female/male ratio, 2.2; mean age, 68.7 years) with CEF were evaluated. Twenty-three (79.3%) patients had a cholecystoduodenal fistula (CDF), four (13.8%) had a cholecystocolonic fistula (CCF), one (3.4%) had a cholecystogastric fistula, and one (3.4%) had a CDF combined with a CCF. Only nine (31.0%) patients obtained a preoperative diagnosis. All patients initially underwent laparoscopic treatment, but five (17.2%) underwent conversion to open surgery; three of these five developed postoperative morbidity or mortality, and the other two had an uneventful postoperative course. Among patients managed successfully by laparoscopy, the hospital stay ranged from 3 to 6 days (mean, 4 days). All patients were asymptomatic at a mean follow-up of 13 months (range, 3–21 months). Conclusion Ultrasound and computed tomography can provide valuable diagnostic clues for CEF. Laparoscopic management of CEF in experienced hands is safe, feasible, and associated with rapid postoperative recovery.
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            Cholecystoenteric fistula with and without gallstone ileus: A case series

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              Cholecystocolonic fistula with a giant colonic gallstone: the mainstay of treatment in an acute setting

              Abstract A cholecystoenteric fistula (CEF) is a rare complication of cholelithiasis with cholecystitis. Cholecystocolonic fistulas (CCFs) account for 8–26.5% of all CEFs. CCFs can cause colonic bleeding, obstruction or perforation, with such complications being mainly reported in the narrower sigmoid colon. Colonic biliary ileus, or obstruction due to the colonic gallstone impaction, is extremely rare in the proximal colon and its best management is yet to be elucidated. We present the case of a 73-year-old male patient with multiple comorbidities and previous abdominal surgeries who presented with hematochezia and intestinal obstructive symptoms. Imaging revealed a giant 5 × 7 cm2 gallstone in the proximal transverse colon. Laparotomy and stone extraction via colotomy were performed. Complicated proximal colonic gallstones are exceedingly rare with several operative and non-operative treatments already described. A time-saving surgery in a patient with serious comorbidities is reasonable when compared to a more extensive procedure including enterolithotomy, cholecystecomy and fistula closure.
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                Author and article information

                Journal
                afm
                Anales de la Facultad de Medicina
                An. Fac. med.
                Universidad Nacional Mayor de San Marcos. Facultad de Medicina (Lima, , Peru )
                1025-5583
                April 2021
                : 82
                : 2
                : 150-154
                Affiliations
                [3] Arequipa orgnameHospital Goyeneche Perú
                [2] Arequipa orgnameHospital Regional Honorio Delgado orgdiv1Asociación de Médicos Residentes Perú
                [4] Arequipa orgnameHospital Cívico Policial MY. Julio Pinto Manrique Perú
                [1] Arequipa orgnameHospital Regional Honorio Delgado Perú
                Article
                S1025-55832021000200150 S1025-5583(21)08200200150
                10.15381/anales.v82i2.21036
                1aa02e15-4351-4c56-b232-86642b8c7746

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 15 July 2021
                : 27 April 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 5
                Product

                SciELO Peru

                Categories
                Reporte de casos

                Acute Cholecystitis,Cholelithiasis,Biliary Fistula,Surgery,Emergencies,Colecistitis Aguda,Colelitiasis,Fístula Biliar,Cirugía,Emergencias

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