Abstract:

Cholecystoenteric fistula (CEF) is a rare but clinically significant complication of gallstone
disease, most commonly developing in patients with long-standing cholelithiasis and chronic
cholecystitis. This article presents a contemporary review of the epidemiology, clinical presentation,
imaging diagnosis, and surgical treatment of cholecystoenteric fistulas, based on data from peerreviewed scientific publications, clinical case reports,retrospective analyses, and systematic reviews.
The most common form is cholecystoduodenal fistula, followed by cholecystocolonic and
cholecystogastric fistulas. The clinical presentation is often nonspecific and may include abdominal
pain, dyspeptic symptoms, chronic diarrhea, or manifestations of complications such as gallstone
ileus, which makes preoperative diagnosis difficult. Computed tomography, magnetic resonance
cholangiopancreatography, and endoscopic methods play an important role in the diagnostic
process, although in a considerable number of cases the diagnosis is established intraoperatively.
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Surgical treatment remains the main therapeutic approach and may include enterolithotomy,
cholecystectomy, and fistula closure, with the choice of operative strategy depending on the patient’s
general condition, the anatomical type of fistula, and the presence of complications. Early
recognition of the condition, accurate interpretation of imaging findings, and timely surgical
intervention are essential for reducing morbidity and improving clinical outcomes

Keywords: cholecystoenteric fistula, cholelithiasis, gallstone ileus, laparoscopic surgery, biliary
complications.

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