Do You Have Gall Bladder Stones? Are You Aware It Can Lead To Cholecystoenteric Fistula?
A lot of people develop medical conditions that can
be more or less categorized into lifestyle diseases. Gall Bladder Stones is one
such condition that medical practitioners attribute to improper diet
habits. These conditions are treatable
upon early diagnosis and proper medications, however, certain times these
conditions can lead to other complications such as Cholecystoenteric Fistula.
What is a Cholecystoenteric Fistula?
Before we can explain what exactly Cholecystoenteric
Fistula is, we would need to explain Fistula first. A Fistula is an abnormal
connection between two epithelialized surfaces (two hollow spaces) in the body,
such as intestines, gall bladder, blood vessels, etc.
is an uncommon complication of cholelithiasis
(gall bladder stones) that arises when there is an abnormal communication
between the gall bladder and an adjacent hollow viscous such as the stomach,
duodenum or colon.
is advisable to go for a thorough check-up at the best super specialty
hospitals in India for early diagnosis and treatment of such conditions,
otherwise, they may lead to further complications.
Causes of Cholecystoenteric Fistula
Fistula can form due to inflammation causing sores or ulcers
inside the organs. The body’s need to create a passage for drainage of pus from
the infected area may result in the creation of an abnormal connection between
spaces, thereby causing Fistula.
in particular usually results due to inflammation of
associated acute cholecystitis (inflammation of Gall bladder) and occurs
between the gallbladder and an adjacent hollow viscous.
A second reason for fistulization is pressure necrosis from a
large stone within the gallbladder lumen.
Signs and Symptoms
patients who develop a cholecystoenteric fistulae do not have any particular
symptoms or signs to indicate the presence of the Fistula pre-operatively.
in other patients, the common symptoms at presentation are those related to
cholecystitis (Gallbladder stones) or complicated cholecystitis.
is usually seen to develop in patients with the long-standing condition of
gallbladder stones. 0.15–4.8% of patients undergoing biliary surgeries may
develop a CEF.
the above-mentioned facts consultation with a specialist at the best
multispecialty hospital in India may increase the chances of diagnosis.
of Cholecystoenteric Fistula
diagnosis is difficult preoperatively and rarely an ultrasound or MRCP may
reveal the presence within the biliary system. In most cases, the Cholecystoenteric
Fistula is suspected intraoperatively (during surgery).
high index of suspicion is required in cases where one finds unusually dense
adhesions (during surgery) around a gall bladder that has a thick and
most common cholecystoenteric fistulae are of the cholecystoduodenal variety
(70%), followed by cholecystocolic (8% to 26.5%) and cholecystogastric
condition of combined fistulae involving gall bladder, colon and intestine are
rare. A patient may present with intestinal
obstruction (gallstone ileus) due to the migration of a stone from the gall
bladder to the intestine through the fistula.
surgical closure of Cholecystoenteric Fistulae is done to prevent the
communication between the gallbladder and intestine or stomach.
to advances and experience in laparoscopy, most surgeons at the best
multispecialty hospital believed that the presence of a cholecystoenteric
fistulae mandated an open surgery for treatment. The reason for such
belief is the presence of dense adhesions that prevents a clear understanding
of the anatomy and increases the risk of dangerous complications.
the view of surgeons has changed over time regarding the requirement of open
surgery for Cholecystoenteric Fistulae treatment.
management is an alternative Cholecystoenteric Fistulae management procedure and
there are now an increasing number of reports on the safe and successful
laparoscopic management of patients with CEF.
Our Experience In Diagnosis and Treatment
Our team at Metro Hospitals have had their share of successful experience of cholecystoenteric
fistulae diagnosis and treatment. Over 2
thousand laparoscopic cholecystectomy were done and out of that, around 35
patients had cholecystoenteric fistulae, which is a high number considering the
rarity of the disease. It is also noteworthy that all cases were diagnosed
Ultrasound was the basic
investigation done in all cases. Overall 23 patients (65.71%) required a
laparotomy. The remaining 12 (34.28%) cases were managed completely by the
It should be noted that the
incidence of successful laparoscopic repair of CEF has increased with our increasing
experience in such procedures.
We at the metro group of hospitals are always
committed to realizing the vision of providing world-class healthcare at an
affordable cost and to achieve excellence in Healthcare services by offering
exceptional care through state-of-the-art technology.
The Metro Group was established in the year
1997 by Padama Vibhusan, Padma Bhusan and Dr. B C Roy National Awardee Dr.
Purshotam Lal with the vision to provide world-class healthcare amenities to
his countrymen at an affordable cost.
Group of Hospitals are the leading healthcare centers in our country boasting
an ultra-modern infrastructure providing multispeciality care by an exceptional
team of healthcare professionals under the leadership of world-renowned
interventional cardiologist Dr. Purshotam Lal. We at Metro hospitals provide
multispecialty care for 35 Chief and Allied-specialities that include
Anaesthesiology, Cardiology & CTVS, Dentistry, Gastroenterology &
Gastro Surgery, Internal Medicine, Neurosciences, Obstetrics and Gynaecology,
Oncology & Onco Surgery, Orthopaedics, Joint Replacement & Spine
Surgery, Paediatrics & Neonatology, Physiotherapy Plastic, Cosmetic &
Reconstructive Surgery, Pulmonology & Sleep Medicine, Rheumatology, Stem
Cell Therapy, Bariatric & Metabolic Surgery, Blood Bank, Dermatology,
Endocrinology And Diabetes, ENT & Cochlear Implant, Haemotology, Holistic
Medicine, Homeopathy, Interventional Radiology Laboratory, Laparoscopic &
General Surgery, Nephrology & Renal Transplant, Nutrition & Health,
Ophthalmology, Metro Eye Centre, Psychiatry, Psychology, Radiology, and
Dr. Purshottam Lal
is an internationally acclaimed Interventional Cardiologist who epitomizes the
best in professional excellence and service to humanity, especially the poor
and the needy.
Lal was trained at world renowned medical institutions in the UK, Germany, and
the USA. He is fellow of American College of Cardiology, American College of
Medicine, Royal College of Physician (Canada), British Cardiovascular
Interventional Society, German Society of Cardiovascular Research, Fellow of
Society of Cardiac Angiography and Interventions, USA, etc. He has the unique distinction of pioneering
the largest number of procedures in the field of Interventional Cardiology for
the first time in the country such as Slow Rotational Angioplasty,
Atherectomy, Rotablator, Stenting, Heart hole closure, etc.
has developed techniques of Aortofemoral bypass support (partial artificial
heart), Opening of tight heart valves with echo without cath lab. He has performed
the first case of Non-surgical heart hole closure (ASD) with monodisc device
and the first case of Non-surgical aortic valve replacement with core valve,
both being the first time in the world. He is the first investigator of Inoue
Balloon Mitral Valvuloplasty in the Country and his name has been listed in the
‘Limca Book of World Records’.
crusader against unethical commercialization of medical services, he has
committed himself to provide to the middle class, poor and the needy the latest
cardio-vascular procedures at the most affordable cost. In pursuance of his
mission, he has established thirteen state-of-the-art Hospitals and three
satellite units. Such is Dr. Lal’s commitment to his mission that an
ever-increasing number of poor patients have been treated either free of cost
or at concessional rates and ‘No patient is ever turned back for want of
money’. He has been named as ‘Creator of
Affordable Healthcare’ by ‘Express Healthcare’, a leading health magazine
and has been a trendsetter for NRIs to return to India to serve the needy
Dr. Lal has been decorated with several prestigious awards:–
Jawaharlal Nehru International Excellence Award (1990), Rajiv Gandhi Award
(1991), Dr.V.V.Shah Oration Gold Medal by Cardiological Society of India (1992)
for his pioneering contributions in Interventional Cardiology.
Achievement Award of Highest Order by the National Forum of Indian Medical
Association (2006-07) for performing the largest number of
angioplasties/stenting as a single operator in the country.
- ‘Life Time
Achievement Award’ by Shri Arun Jaitley on behalf of Delhi Medical Association
and ‘Life Time Achievement Award’ by Dr. Lilly Engineer, Professor of Harvard
University on behalf of ‘Times of India’.
- Padma Bhushan
(2003), prestigious Dr. B.C.Roy National Award (2004) and Padma Vibhushan (2009) by the President
He has contributed over one hundred research papers, articles,
chapters and authored a book “Cause and Prevention of Heart Diseases”. He has
been a Member at Central Council of Health and Family Welfare, Expert Committee
for medical devices, Ministry of Health, Govt. of India, Delhi Medical Council,
Standing Committee ESI Corporation – Ministry of Labour & Employment, Govt.
of India and Member Board of Governors, Medical Council of India from May 2011
to May 2013.