A Rare Occurrence of Choledochoduodenal Fistula in a Patient with Obstructive Jaundice Secondary to Pancreatic Cancer after Biliary Stent Placement

Dr Nitin Sherkar; Dr. Pankaj Takarkhede; Dr Bhupendra Mehra; Dr Siddharth Dubhashi; Dr Prashant Sawarkar

doi:10.23958/ijirms/vol10-i06/2087

Abstract

Intestinal perforation post biliary stent placement is extremely uncommon and is induced by different factors. Choledochoduodenal fistula (CDF) caused by biliary stent-induced perforation is also rare occurrence. We present a case of obstructive jaundice due to pancreatic cancer with a development of CDF following biliary stent placement and was managed by Whipple’s procedure successfully. CDF could have resulted from a bile duct rupture induced by pressure necrosis and inflammation generated by direct contact between the common bile duct and the stent's edge.

Keywords

Choledochoduodenal fistulaBiliary StentPancreatic CarcinomaObstructive jaundiceWhipple’s procedure

References

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Lee TH, Park SH, Kim SP, et al. Spontaneous choledochoduodenal fistula after metallic biliary stent placement in a patient with ampulla of vater carcinoma. Gut and liver. 2009;3(4):360.Google Scholar ↗
Sundaram S, Sawrav S, Ramani N, et al. An Extremely Unusual Complication of Biliary Metallic Stenting:Transhepatic Entero-Peritoneal Fistula. Diagn Interv Endosc. 2022;1(1):21-23.Google Scholar ↗
Dadzan E, Akhondi H. Choledochoduodenal fistula presenting with pneumobilia in a patient with gallbladder cancer: a case report. Journal of medical case reports.2012;6:1-4.Google Scholar ↗
Wu MB, Zhang WF, Zhang YL, et al. Choledochoduodenal fistula in Mainland China: a review of epidemiology, etiology, diagnosis and management. Annals of surgical treatment and research. 2015;89(5):240.Google Scholar ↗
Lam R, Muniraj T. Fully covered metal biliary stents: A review of the literature. World Journal of Gastroenterology. 2021;27(38):6357.Google Scholar ↗
Ryozawa S, Akiyama T, Ikeda M, et al. A case of cholangioduodenal fistula formation after metallic stenting for malignant biliary stricture. Digestive Endoscopy. 1995;7(3):306-309.Google Scholar ↗
Krokidis ME, Hatzidakis AA, Manousaki EG, et al. Late migration of two covered biliary stents through a spontaneous bilioenteric fistula in a patient with malignant biliary obstruction. CardioVascular and Interventional Radiology. 2008;31:222-225.Google Scholar ↗
Zong KC, You HB, Gong JP, et al. Diagnosis and management of choledochoduodenal fistula. The American Surgeon. 2011;77(3):348-350.Google Scholar ↗
Li ZH, Ding J, Ye Y, et al. New strategy to prevent ascending cholangitis in larger choledochoduodenal fistula. ANZ journal of surgery. 2006;76(9):796-800.Google Scholar ↗

[refR-1] Katakura Y, Asaki T, Adachi S, et al. Late Migration of Covered Metal Stent to the Stomach Through a Spontaneous Choledochoduodenal Fistula in a Patient with Malignant Biliary Obstruction. Gastroenterology Research. 2012;5(3):133.Google Scholar ↗

[refR-2] Lee TH, Park SH, Kim SP, et al. Spontaneous choledochoduodenal fistula after metallic biliary stent placement in a patient with ampulla of vater carcinoma. Gut and liver. 2009;3(4):360.Google Scholar ↗

[refR-3] Sundaram S, Sawrav S, Ramani N, et al. An Extremely Unusual Complication of Biliary Metallic Stenting:Transhepatic Entero-Peritoneal Fistula. Diagn Interv Endosc. 2022;1(1):21-23.Google Scholar ↗

[refR-4] Dadzan E, Akhondi H. Choledochoduodenal fistula presenting with pneumobilia in a patient with gallbladder cancer: a case report. Journal of medical case reports.2012;6:1-4.Google Scholar ↗

[refR-5] Wu MB, Zhang WF, Zhang YL, et al. Choledochoduodenal fistula in Mainland China: a review of epidemiology, etiology, diagnosis and management. Annals of surgical treatment and research. 2015;89(5):240.Google Scholar ↗

[refR-6] Lam R, Muniraj T. Fully covered metal biliary stents: A review of the literature. World Journal of Gastroenterology. 2021;27(38):6357.Google Scholar ↗

[refR-7] Ryozawa S, Akiyama T, Ikeda M, et al. A case of cholangioduodenal fistula formation after metallic stenting for malignant biliary stricture. Digestive Endoscopy. 1995;7(3):306-309.Google Scholar ↗

[refR-8] Krokidis ME, Hatzidakis AA, Manousaki EG, et al. Late migration of two covered biliary stents through a spontaneous bilioenteric fistula in a patient with malignant biliary obstruction. CardioVascular and Interventional Radiology. 2008;31:222-225.Google Scholar ↗

[refR-9] Zong KC, You HB, Gong JP, et al. Diagnosis and management of choledochoduodenal fistula. The American Surgeon. 2011;77(3):348-350.Google Scholar ↗

[refR-10] Li ZH, Ding J, Ye Y, et al. New strategy to prevent ascending cholangitis in larger choledochoduodenal fistula. ANZ journal of surgery. 2006;76(9):796-800.Google Scholar ↗