Rolling Stones Management of Gallstone Ileus Through a Single-Institution Retrospective Analysis

Biliodigestive fistulas are a complication of gastrointestinal pathologies, often arising from chronic recurrent cholecystitis. These fistulas disrupt normal biliary physiology, leading to bile reflux or the entry of intestinal contents into the biliary system, with gallstone ileus as a significant consequence. This condition typically results in mechanical bowel obstruction due to the migration of gallstones into the intestinal lumen. Diagnosis can be challenging due to nonspecific symptoms, and surgical intervention is often required. This retrospective study reviews cases of gallstone ileus at a single institution, focusing on clinical presentation, diagnostic methods, surgical approaches, and outcomes. Eight patients, all elderly females with an average age of 77 years, presented with symptoms such as abdominal pain, vomiting, and absence of evacuation. Imaging played a crucial role in diagnosis, and surgical management was primarily enterolithotomy. Mortality was notable, with comorbidities contributing to poor outcomes. The findings suggest that a personalized, staged surgical approach may be beneficial, particularly for high-risk patients. This study highlights the importance of considering biliodigestive fistulas in the differential diagnosis of intestinal obstruction and the need for further research into optimal treatment strategies.