Repair of cholecystocholedochal fistulas using gallbladder patching.

Spontaneous cholecystocholedochal fistulas are a rare but serious complication of calculous biliary tract disease. An effective repair technique that has good long-term results is to close the defect in the common duct wall by utilizing the proximal part of the gallbladder as a pedicled graft. A T-tube drain inserted into the common duct should be maintained postoperatively until there is firm evidence of free passage of bile into the duodenum.