Massive CBD Stone & Rare Fistula Fixed with Scar-Free Laparoscopic Surgery

A woman from Bihar, suffering from unbearable abdominal pain for days, was told she had to wait five months for open surgery after a failed ERCP. When she came at Sarvodaya Hospital, Sec 8, Faridabad, Dr. Arjun Goel, Senior Consultant & Head – General & Minimally Invasive Surgery and his team performed a rare and complex laparoscopic procedure — removing a massive 2 cm CBD stone and repairing a cholecysto-colic fistula in the same sitting. Just 24 hours later, she walked out of the hospital pain-free.

The Patient’s Condition

Sushma had been living with chronic abdominal pain that disrupted her daily life. She underwent ERCP, but the procedure failed to clear the obstruction. Further investigations revealed:

• A large CBD stone (2 cm) blocking bile flow.
  
  
• Cholecysto-colic fistula, a rare complication where the gallbladder forms an abnormal connection with the colon.

This combination made her case particularly complex.

Diagnosis

The failed ERCP and advanced imaging confirmed the dual problem — a massive CBD stone and a fistula caused by long-standing gallstone disease. She was advised to undergo open surgery, with a surgery date given after five months.

Treatment

Instead of waiting, Sushma came to our hospital. Here, the surgical team decided to attempt laparoscopic management — a minimally invasive approach that would:

• Remove the CBD stone through laparoscopic CBD exploration.
• Repair the cholecysto-colic fistula in the same sitting.

The surgery was difficult due to dense adhesions and altered anatomy, but was completed successfully in 2.5 hours.

Benefits of the Procedure

• Single sitting for both problems — no need for multiple surgeries.
• Minimally invasive — smaller cuts, less pain, and faster recovery.
• Quick discharge — patient went home the very next day.
• Avoided long waiting time for open surgery.

This rare case highlights how advanced laparoscopic skills and timely intervention can spare patients from prolonged suffering and long surgical wait times — even in the most complex scenarios.