# Post Cholecystectomy Choledochoduodenal Fistula: A Case Report

## TL;DR

This case report describes a patient with a rare bile duct fistula after gallbladder removal, treated surgically due to recurring pain and complications.

## Contribution

The paper presents a novel clinical case of choledochoduodenal fistula following cholecystectomy and highlights surgical intervention as a treatment option.

## Key findings

- Choledochoduodenal fistula was diagnosed via Endoscopic Retrograde Cholangiopancreatography in a patient with long-standing choledocholithiasis.
- Surgical intervention was indicated due to recurrent pain and non-resolving medical treatment.
- Surgery is recommended for complicated or refractory cases of choledochoduodenal fistula.

## Abstract

Choledochoduodenal fistula is an abnormal connection between the common bile duct and the duodenum. The commonest cause is cholecystolithiasis, however, other causes are iatrogenic factors, bile duct stones (choledocholithiasis), and chronic duodenal ulcers. Here, we report a case of choledochoduodenal fistula secondary to long standing choledocholithiasis post cholecystectomy who presented with intermittent abdominal pain in the past three years which revealed choledochoduodenal fistula during Endoscopic Retrograde Cholangiopancreatography. As the patient had recurrent pain along with choledocholithiasis, surgical intervention was indicated. Choledochoduodenal fistula is suspected in case of recurrent cholangitis and surgery is recommended for refractory and complicated cases. Surgical treatment is also recommended for larger fistulas and especially with non-resolving medical treatment. This case highlights the treatment option for choledocholithiasis with choledochoduodenal fistula.