Surgical treatment of gallstone ileus

Seven cases of gallstone ileus are presented. It is suggested that the mechanism of intestinal obstruction is not by progressive enlargement of the stone. Recurrent gallstone ileus is reviewed. At the time of the primary operation for the relief of the intestinal obstruction, the gallbladder should be palpated, if possible. When stones are palpable they should be removed by a cholecystostomy to prevent early recurrence of gallstone ileus. The decision to do further immediate surgery on the biliary tree depends on the condition of the patient.