[Biliary ileus: enterolithotomy only or radical surgery?]

Eleven patients, 8 women and 3 men, mean age 69.9 years (range 54-81) were operated with a gallstone ileus during a seven years period. Echography and barium study of small bowel were made in 8 and 2 patients, and gave a diagnostic rate of 37% and 100%, respectively. A preoperative diagnosis was made in 72.2% of cases, simple enterolithotomy was made in 8 cases and in three cases a definitive treatment of biliary pathology was added. There was no mortality and a major complication was observed in 1 patient without biliary surgery (evisceration and recurrence of biliary ileus); no major complications were seen in patients with primary biliary surgery. With a careful, selection, surgery can be made without mortality nor morbidity.