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Published on: December 4, 2023
Gallstone ileus: a single-center experience
Fatih Feratoğlu1, Cemal Hacıalioğlu2, Tarık Emre Yılmaz3
1Department of General Surgery, Medical Park Göztepe Hospital, İstanbul-Türkiye; Department of General Surgery, Kartal Dr. Lütfi Kirdar City Hospital, University of Health Sciences, İstanbul-Türkiye.
Summary
Gallstone ileus (GSI) is a rare surgical emergency. Prompt diagnosis and individualized treatment, often omitting routine cholecystectomy, improve outcomes and reduce hospital stays.
Area of Science:
- Gastroenterology
- Surgical Emergency
- Abdominal Surgery
Background:
- Gallstone ileus (GSI) is a rare but serious surgical condition.
- Diagnosis of GSI is often delayed, complicating management.
- Optimal surgical strategy, including cholecystectomy and fistula repair, remains debated.
Purpose of the Study:
- To present clinical experience with GSI.
- To discuss diagnostic and therapeutic strategies.
- To review current literature on GSI management.
Main Methods:
- Retrospective review of 13 patients undergoing surgery for GSI (2017-2022).
- Analysis of diagnostic timing, surgical approach, and patient outcomes.
- Comparison between early and delayed diagnoses.
Main Results:
- Delayed diagnosis occurred in 30.7% of patients, leading to significantly longer surgery times and hospital stays.
- Eleven patients had surgery for obstruction only; two had additional cholecystectomy and fistula repair.
- No recurrent GSI, gallbladder cancer, or cholangitis observed during follow-up in patients without fistula repair.
Conclusions:
- Accurate and timely diagnosis of GSI is crucial for reducing delays and hospital stay.
- Routine cholecystectomy and fistula repair are not supported by current evidence for all GSI cases.
- Individualized surgical management is recommended, with cholecystectomy considered if other gallstones are present.
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