Abstract
We report a case of cholecysto-choledochal fistula complicated by Mirizzi syndrome successfully treated with a ligamentum teres hepatis patch. The patient was a 48-year-old man with liver dysfunction, diagnosed with Mirizzi syndrome by radiological findings. Magnetic resonance cholang iopancreatography (MRCP) showed 3 cm gallstones in the cystic duct compressing and narrowing the common bile duct. The liver dysfunction was treated with endoscopic naso-biliary drainage (ENBD) and he was suspected to have cholecysto-choledochal fistula preoperatively. At surgery, we found a cholecysto-choledochal fistula 1 cm in diameter via the endoscopic nasobiliary drainage (ENBD) tube and performed a ligamentum teres hepatis patch to close the fistula, because of inflammation around the gall bladder and common bile duct. His postoperative course was unremarkable. The ligamentum teres hepatis patch is an alternative novel method for the closure of a biliary fistula when simple closure or gall bladder patch is impossible due to inflammation.
