Spontaneous cholecystocutaneous fistulas1

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Spontaneous cholecystocutaneous fistula is rarely seen today because of the increased frequency and relative safety of biliary surgery. Chronic gallbladder inflammation secondary to calculous disease is the most frequent cause. Initial therapy consists of local drainage; a contrast-enhanced study of the fistulous tract should then be obtained. Definitive therapy consists of excision of the fistula, cholecystectomy, and intraoperative cholangiography. This problem occurs more frequently in the stoical, elderly patient with neglected biliary disease. A case is presented, along with a review of the literature.



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