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[Gallstone ileus. Our experience]

L Giani1, P Nobili, G L Corti

  • 1Divisione di Chirurgia Generale, Ospedale di Desio Mi.

Il Giornale Di Chirurgia
|May 1, 1995
PubMed
Summary
This summary is machine-generated.

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Gallstone ileus treatment: Enterolithotomy alone is safer than one-stage procedures. Cholecysto-enteric fistula repair should be delayed unless symptoms persist or recur.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Abdominal Surgery

Background:

  • Gallstone ileus is a rare complication of gallstones.
  • Diagnosis can be challenging, often requiring multiple imaging modalities.
  • Surgical management strategies vary, impacting patient outcomes.

Purpose of the Study:

  • To evaluate the outcomes of different surgical approaches for gallstone ileus.
  • To determine the optimal surgical strategy for managing gallstone ileus and associated fistulas.

Main Methods:

  • Retrospective review of five patients treated for gallstone ileus over 10 years.
  • Analysis of diagnostic methods used (plain radiography, ultrasonography, gastroduodenoscopy).
  • Comparison of outcomes between one-stage procedures (stone removal, fistula repair, cholecystectomy) and enterolithotomy alone.

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Main Results:

  • Plain abdominal radiography was diagnostic in only 2 of 5 patients.
  • Obstructing stones were located in the terminal ileum (3 patients) and duodenum (2 patients).
  • One-stage procedures resulted in mortality in 2 of 3 patients, while enterolithotomy alone had no mortality.

Conclusions:

  • Enterolithotomy alone is recommended as the standard surgical procedure for gallstone ileus.
  • Cholecysto-enteric fistula repair should be considered an elective procedure, performed only if symptoms continue or recur.