Cholecystocolonic Fistula Diagnosed Intraoperatively and Managed Laparoscopically: A Case Report

Abstract Cholecystocolonic fistula (CCF) is a rare condition, accounting for 8% of cholecysto-enteric fistulas (CEF). It often presents with vague symptoms resembling gallstones and is commonly diagnosed during surgery. Treatment options depend on the extent of the disease and available resources. Owing to its rarity, the literature on CCF mainly consists of case reports. This case report describes a successful laparoscopic management of CCF during cholecystectomy. This report presents the case of a 67-year-old man with a medical history of diabetes, hypertension, and ischemic heart disease. He presented with right upper quadrant pain, and during laparoscopic cholecystectomy for cholecystitis, a CCF was discovered incidentally. The laparoscopic procedure involved dissecting and excising the fistulous tract by using an Endo-GIA™ stapler. The patient’s postoperative recovery was uneventful, and he was discharged without complications. CCF is a rare complication of chronic cholecystitis or other inflammatory conditions in the gallbladder. Preoperative diagnosis is challenging, and most cases are discovered during surgery. Imaging and endoscopy can aid diagnosis. Laparoscopic cholecystectomy is the preferred treatment, involving closure of the fistula by using sutures, Endoloop®, or Endostapler. In complex cases, open surgery may be necessary. CCF is a rare condition with nonspecific symptoms and difficult preoperative diagnosis. Surgeons should be aware of this condition, especially when operating on severely inflamed gallbladders. Management should be individualized by considering the surgeon’s expertise and available instruments.