Laparoscopic treatment of ureteroduodenal fistula: Case report, technique, and review.

Ureteroduodenal fistula is extremely rare, with fewer than 20 reported cases. We describe a 50-year-old woman with recurrent flank pain and hematuria whose imaging showed proximal ureteral hydronephrosis, a 2-cm stone, and a migrated metallic foreign body. During laparoscopic ureterolithotomy, dense adhesions revealed a fistula caused by transduodenal needle penetration with associated stone formation. Laparoscopic removal of the stone and foreign body, duodenal repair, and ureteral suturing with stent placement were successfully performed. The patient recovered uneventfully and remained asymptomatic at 6 months. This represents the first laparoscopic management of ureteroduodenal fistula, highlighting a safe, kidney-sparing alternative to open surgery.