Two Cases of Cholecystoduodenal Fistula That Closed Spontaneously During Follow-up

Abstract

Cholecystoduodenal fistula is a type of internal biliary fistula formation between the biliary system and the gastrointestinal tract, that may lead to gallstone ileus or Bouveret syndrome as a result of gallstone migration into the intestinal lumen. Although relief of intestinal obstruction is the cornerstone of treatment, there is no consensus regarding the indications for cholecystectomy or fistula closure. Herein, we report two cases of cholecystoduodenal fistula in which spontaneous closure of the fistula was confirmed during follow-up after treatment for enteric gallstones and conservative management. In patients without residual gallstones in the gallbladder and with resolved inflammation, careful observation based on the expectation of spontaneous fistula closure may represent a reasonable therapeutic option.