Gallstone Ileus. What therapeutic options are there?

Area of Science:

• Gastroenterology
• Surgical Practice
• Emergency Medicine

Background:

• Gallstone ileus is a rare surgical emergency with challenging diagnosis.
• It involves gallstones obstructing the gastrointestinal tract, often due to a cholecystoenteric fistula.

Purpose of the Study:

• To review clinical outcomes of patients treated for gallstone ileus.
• To evaluate surgical approaches and patient outcomes.

Main Methods:

• Retrospective review of clinical, operative, and follow-up data for 14 consecutive patients.
• Analysis of surgical procedures including enterolithotomy, cholecystectomy, and fistula repair.

Main Results:

• Gallstone ileus occurred in 0.06% of biliary lithiasis operations and 1% of enteric occlusions.
• 13 patients had cholecystoduodenal fistula, 1 had cholecystocolonic fistula.
• Enterolithotomy alone was performed in 8 cases, with shorter postoperative stays (9.4 days) compared to radical treatment (18.6 days).

Conclusions:

• Gallstone ileus must be considered in patients with intestinal obstruction and a history of biliary disease.
• One-stage surgery is recommended for stable patients.
• Enterolithotomy alone is a viable option for patients with significant comorbidities.