Robotic-assisted completion cholecystectomy with repair of cholecystoduodenal fistula.

Abstract

Post-cholecystectomy syndrome (PCS) is a well-documented complication of incomplete cholecystectomy. The etiology is often post-surgical chronic inflammation from unresolved cholelithiasis, which is secondary to anatomical abnormalities, including a retained gallbladder or a large cystic duct remnant (CDR). An exceedingly rare consequence is retained gallstone fistulization into the gastrointestinal tract. We present a case of a 70-year-old female with multiple comorbidities 4 years status-post incomplete cholecystectomy, who developed PCS with cholecystoduodenal fistula secondary to retained gallstone in the remnant gallbladder, with CDR involvement, treated via robotic-assisted surgery. Reoperation in PCS has been traditionally performed via laparoscopic approach with recent advances made in robotic-assisted surgery. However, we report the first documented case of PCS complicated by bilioenteric fistula repaired with robotic-assisted surgery. This highlights the value of robotic-assisted surgery in complicated cases, where one must contend with post-surgical anatomic abnormalities and visualization difficulties. Subsequent investigation is necessary to objectively quantify the safety and reproducibility of our approach.

• Authors: Joshua C Hurwitz, Christine E Kolwitz, David Y Kim, Patrizio Petrone, David K Halpern
• Journal: Journal of surgical case reports (J Surg Case Rep) Vol. 2023 Issue 5 Pg. rjad251 (May 2023) ISSN: 2042-8812 [Print] England
• PMID: 37201105 (Publication Type: Case Reports)
• Copyright: Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2023.