A case of cholecystocolic fistula caused by obstructive cholecystitis due to advanced cancer of the gallbladder

Abstract

A 65-year-old man was referred to our hospital due to elevated lesion of the gallbladder on US. CT showed that enhanced elevated lesion of the neck of the gallbladder and enhanced wall thickness of the body and fundus of the gallbladder, and direct invasion into the liver and transverse colon (cholecystocolic fistula) was suspected. Imaging revealed advanced gallbladder cancer was most likely, but xanthogranulomatous cholecystitis was not excluded. First, staging laparoscopy was performed to confirm no dissemination and liver metastases. Then, we performed cholecystectomy with partial hepatectomy, partial resection of transverse colon and abdominal wall. Histopathological examination revealed a moderately differentiated tubular adenocarcinoma of the gallbladder (T3, N0, M0, stage III), and existence of cholecystocolic fistula without cancer invasion. Formation of cholecystocolic fistula might be caused by obstructive cholecystitis, not cancer invasion.