Since the first laparoscopic cholecystectomy in 1987 by Mouret, the sc
ope of biliary surgery available to a laparoscopic surgeon has increas
ed. In the early days of the procedure there were several accepted con
traindications. Some of these were acute cholecystitis, morbid obesity
, adherent gallbladder, jaundiced patients, ductal calculi, and biliar
y tract anomalies. In a series of 300 laparoscopic cholecystectomies w
e encountered five cholecystoduodenal fistulae. It was possible to dea
l with four fistulae laparoscopically. Two patients underwent a laparo
tomy, one for a failed laparoscopic repair of cholecystoduodenal fistu
la and the other for several common bile duct (CBD) stones, which coul
d not be removed laparoscopically via the cystic duct. We maintain tha
t with increasing expertise and improved instrumentation, most cases o
f cholecystoduodenal fistula could be dealt with laparoscopically.