Gallstone ileus: revisiting surgical outcomes using National Surgical Quality Improvement Program data

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Gallstone Ileus Management

Background:

• Gallstone ileus surgical management is standard, but optimal approach is debated.
• Previous studies relied on small, single-center data.
• Need for larger studies on surgical outcomes for gallstone ileus.

Purpose of the Study:

• Review outcomes of surgical gallstone ileus management.
• Determine if cholecystectomy plus enterolithotomy increases morbidity/mortality.

Main Methods:

• Analyzed 127 patients (2005-2010) from ACS NSQIP database.
• Compared outcomes of enterolithotomy alone vs. with cholecystectomy.
• Assessed demographics, comorbidities, operative time, and 30-day outcomes.

Main Results:

• Overall 30-day morbidity was 35.4%, mortality 5.5%.
• No significant mortality difference between groups (5.3% vs. 7.1%).
• Cholecystectomy group had more minor complications and longer hospitalization.

Conclusions:

• Modern surgical gallstone ileus treatment is less morbid than previously reported.
• Concurrent cholecystectomy does not improve mortality.
• Insufficient evidence supports routine concurrent cholecystectomy for gallstone ileus.