Laparoscopic-Assisted Enterolithotomy for Recurrent Gallstone Ileus: A Case Report.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Nephrology

Background:

• Gallstone ileus is a rare complication of gallstones, causing small bowel obstruction via a fistula between the gallbladder and GI tract.
• Surgical options include one-stage or two-stage procedures, with simple enterolithotomy also utilized.
• Laparoscopic-assisted enterolithotomy has become preferred over open surgery due to improved safety and speed.

Observation:

• A 68-year-old female with multiple comorbidities presented with gallstone ileus and was treated with laparoscopic-assisted enterolithotomy.
• The patient experienced a recurrence of gallstone ileus seven days post-surgery, necessitating reoperation.
• Repeat laparoscopic-assisted enterolithotomy was performed without complications, leading to symptom resolution.

Findings:

• Recurrent gallstone ileus can be effectively managed with repeat laparoscopic-assisted enterolithotomy.
• Computed tomography (CT) scans are vital for distinguishing recurrent gallstone ileus from postoperative ileus.
• Simple laparoscopic-assisted enterolithotomy is associated with reduced morbidity, mortality, and operative time.

Implications:

• Laparoscopic-assisted enterolithotomy offers a safe and effective treatment for recurrent gallstone ileus.
• The case highlights the importance of accurate diagnostic imaging and vigilant patient follow-up.
• Further research is needed to establish a gold standard surgical approach for gallstone ileus management.