Diagnosis and treatment of gallstone ileus. Report of 83 cases

83 patients with gallstone ileus treated at 6 hospitals in Sweden during 1960-1979 are presented. Overall mortality was 26.5%. The high age (mean 75 years) and poor general condition of many patients seem to be the main reason for the high mortality rate. 76 patients (92%) were laparotomized and in 63 (76%) the operative procedure was limited to enterolihotomy. Three of these patients had later a second attack of gallstone ileus; other late complications of the gallbladder disease were rare and less serious. In three patients a cholecystectomy was added to enterolithotomy. The postoperative period for these patients was uneventful while postoperative mortality was high (60%) in 5 patients operated with enterolithotomy and small intestinal resection.