A 79-year-old male who, after scheduled laparoscopic cholecystectomy due to anatomical difficulties, debuts from the first postoperative day with external biliary fistula by environmental drainage.
In the imaging tests performed, some of them repeated even twice (ultrasound, CT, CT with pigtail drainage of the biloma, cMRI, diagnostic RFCP and subsequent normal biliary fistula with placement of biliary fistula even 10 cm
The output of the external biliary fistula, however, ranged between 200 and 400 cc daily.
Elevated cholesterol levels were defined as:
Despite the internal biliary drainage of the main bile duct, the persistence of biliary fistula led us to suspect that we were faced with an external bile duct interpretation during surgery, so we decided to identify difficulties 45 days after initial cholecystectomy,
Only intraoperatively the practice of a cholangiography through the mouthpiece of the juxtahiliary biliary fistula demonstrated that the patient was originated in an intra-gastric lesion with a diagnostic loop and a segmental anterior bile duct defect V.
On the 7th postoperative day a transcatheter cholangiography was performed with absolute normality of the anastomosis and absence of leaks. The patient was discharged.
The transanastomotic tutor was removed one month after surgery after a second cholangiographic control demonstrating the complete integrity and functionality of the anastomosis performed.
In the annual controls the patient maintains a normal total of the analytical tests.
