# Cystic Duct Remnant–Duodenal Fistula following Laparoscopic Cholecystectomy: A Case Report and Literature Review

## TL;DR

This paper reports a rare case of a fistula between the cystic duct and duodenum after a common gallbladder surgery and reviews treatment options.

## Contribution

The paper presents a rare clinical case and provides insights into effective interventions for managing such fistulas.

## Key findings

- A fistula formed between the cystic duct stump and duodenum after laparoscopic cholecystectomy.
- ERCP and stent placement are emphasized as effective interventions for fistula closure.
- Transpapillary pressure gradient is a key factor in fistula development and treatment.

## Abstract

Laparoscopic cholecystectomy is the most common procedure performed for the management of symptomatic gallstone disease. This, however, can be complicated by the formation of fistulous communications between the biliary tree and the gastrointestinal tract. This abnormal communication allows for the flow of bile and bowel contents between two systems (biliary system and intestine), which can cause abdominal pain, nausea, vomiting, and biliary sepsis. We would like to present a rare case of fistulous communication between the cystic duct stump and duodenum and outline possible contributing factors. The literature review describes the most common interventions for the management of fistulas with emphasis on ERCP and stent preferences to eliminate transpapillary pressure gradient, which directly contributes to fistula closure.