Biliary-Colonic Fistula Associated With High-Grade Biliary Stenosis From Errant Surgical Clip During Previous Biliary Surgery: Diagnosis and Treatment By ERCP

Abstract

A 65-year-old woman, status-post cholecystectomy and Roux-en-Y hepaticojejunostomy (circumstances unknown, 2017), was admitted (2020) for right upper quadrant abdominal pain and pyrexia for 3 days. Physical examination revealed a temperature of 39.1°C; no jaundice; soft, nondistended abdomen; and right upper quadrant tenderness.

ERCP combined with colonoscopy in the treatment of biliary-colonic fistula: case report and literature review

“…A fully covered SEMS was successfully placed and improved the patient's chronic diarrhea. In a separate case, an incorrect surgical clip was placed during the operation that led to a biliary-colonic fistula as identified by ERCP [ 6 ]; the patient accepted laparotomy after a plastic biliary stent was placed for decompression. Francisco Igor B. Macedo et al [ 7 ] reported on one patient who had undergone laparoscopic cholecystectomy, and magnetic resonance cholangiopancreatography (MRCP) identified a fistula between the biliary tree and intestinal canal; this patient required biliary reconstruction.…”

“…However, the situation of a biliary-colonic fistula is more complex. In the past, biliary-tract reconstruction surgery was more common than ERCP alone [ 3 , 6 ]. We present a new combined endoscopic application technique to treat biliary-colonic fistulas in a minimally invasive manner, thus avoiding the second surgical operation.…”