{
  "abstract": "A patient in their 70s presented for delayed cholecystectomy 6 weeks after admission for treatment of gallstone pancreatitis. They were managed non-operatively during their index admission due to new-onset arrhythmias and acute hypoxic respiratory failure. After discharge, they were medically optimized and reported resolution of symptoms prior to operation. Intraoperatively, however, it was found that the patient’s pancreatitis had evolved considerably, necessitating conversion to open cholecystectomy. There was extensive periduodenal and pericholecystic inflammation due to pancreatic necrosis that significantly distorted the anatomy of the cystic plate, therefore intraoperative esophagogastroduodenoscopy (EGD) was performed to aid in identification and protection of the duodenum. Pancreatic necrosis near the pylorus and portal triad was resected to aid visualization of the gallbladder. The dome of the gallbladder was identified and mobilized in a top-down fashion, but the infundibulum and cystic duct were fused to the duodenum, therefore fenestrated subtotal cholecystectomy was performed, and a 19-French Jackson-Pratt (JP) drain was left within the gallbladder fossa. Pathological findings were negative for malignancy, and the patient was discharged on postoperative day 5 after an uneventful course with JP drain in place. The patient returned to the clinic 2 weeks postdischarge, and the drain was left in place due to continued high purulent output with plans to return to the clinic to monitor drain output. The patient was lost to follow-up.",
  "authors": [
    {
      "affiliations": [
        "Rocky Vista University College of Osteopathic Medicine, Englewood, Colorado, USA"
      ],
      "name": "Anna Sater"
    },
    {
      "affiliations": [
        "Department of Surgery, UC Health University of Colorado Hospital, Aurora, Colorado, USA"
      ],
      "name": "Steffen Meiler"
    },
    {
      "affiliations": [
        "Surgery, University of Colorado, Aurora, Colorado, USA"
      ],
      "name": "Whitney Renee Jenson"
    },
    {
      "affiliations": [
        "Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA"
      ],
      "name": "Kristy Lynn Hawley"
    },
    {
      "affiliations": [
        "Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA"
      ],
      "name": "William Aaron Marshall"
    }
  ],
  "title": "Drain erosion into duodenum after cholecystectomy",
  "uid": "44006746-67b2-5bb9-acf4-ac01031a17c0"
}