[Gallstone ileus in cholecystoduodenal fistula]

Operations were performed on 15 patients with obturation gallstone ileus, 8 of them had a cholecystoduodenal fistula and the authors analysed their case records. It is most difficult to establish the diagnosis of the subacute form of the disease which is caused by slow movement of the stone in the intestine, which conceals the clinical picture and leads to delay of operation. The operation of choice is resection of the small intestine together with the stone or enterotomy with obligatory evacuation of contents from the proximal parts of the intestine. The mortality in the group of patients operated on later than on day 4 after the onset of the disease is very high and, according to our data, it is 100%. An obligatory condition of the operation is evacuation of the contents from the intestine in order to reduce intoxication and prevent endotoxic shock.