A Case of Gallstone Ileus with Cholecystoduodenal Fistula Treated by Single–port Laparoscopic Surgery

Abstract

An 84–year–old Japanese man with a history of cervical spine injury, diabetes mellitus, and coronary artery bypass surgery presented to us with vomiting and abdominal pain. Abdominal computed tomography (CT) showed calcification in the duodenum and adhesions on the gallbladder and duodenum. We made the diagnosis of gallstone ileus with a cholecystoduodenal fistula. Initial conservative therapy by insertion of a gastric tube did not elicit satisfactory response, therefore, surgery was performed. Enterolithotomy was successfully performed by single–incision laparoscopic surgery. No additional surgery, such as cholecystectomy or resection of the cholecystoduodenal fistula, was performed. The fistula had closed spontaneously, with no complications, by 2 months postoperatively.