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GALLSTONE ILEUS: RARE AND STILL CONTROVERSIAL

GALLSTONE ILEUS: RARE AND STILL CONTROVERSIAL Background: Gallstone ileus is a rare disease and accounts for about 1−3% of mechanic ileus of the small bowel, but for 25% of all small bowel obstructions in patients older than 65 years. Concomitant cardiorespiratory diseases or diabetes are frequent in older patients and responsible for the high mortality rate. The aim of the present study was to evaluate and discuss different surgical approaches and to analyze the clinical outcome. Methods: Four patients with a mean age of 72 years were treated for gallstone ileus at our hospital in the last 10 years. Patients history, operative strategy and their outcome is elucidated and a review of the recent literature is given. Results: In all patients the operative strategy was a one‐stage procedure including enterolithotomy, cholecystectomy and closure of the fistula. The 30‐day mortality rate was 25%. Conclusion: One‐stage procedure prevents from cholangitis, cholecystitis and recurrent ileus caused by further gallstones but bears the risk of enteric or biliary leakage after fistula closure. It should therefore be reserved for patients presenting in good general condition with a low degree of cholecystitis. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Anz Journal of Surgery Wiley

GALLSTONE ILEUS: RARE AND STILL CONTROVERSIAL

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References (38)

Publisher
Wiley
Copyright
Copyright © 2005 Wiley Subscription Services, Inc., A Wiley Company
ISSN
1445-1433
eISSN
1445-2197
DOI
10.1111/j.1445-2197.2005.03368.x
pmid
15839973
Publisher site
See Article on Publisher Site

Abstract

Background: Gallstone ileus is a rare disease and accounts for about 1−3% of mechanic ileus of the small bowel, but for 25% of all small bowel obstructions in patients older than 65 years. Concomitant cardiorespiratory diseases or diabetes are frequent in older patients and responsible for the high mortality rate. The aim of the present study was to evaluate and discuss different surgical approaches and to analyze the clinical outcome. Methods: Four patients with a mean age of 72 years were treated for gallstone ileus at our hospital in the last 10 years. Patients history, operative strategy and their outcome is elucidated and a review of the recent literature is given. Results: In all patients the operative strategy was a one‐stage procedure including enterolithotomy, cholecystectomy and closure of the fistula. The 30‐day mortality rate was 25%. Conclusion: One‐stage procedure prevents from cholangitis, cholecystitis and recurrent ileus caused by further gallstones but bears the risk of enteric or biliary leakage after fistula closure. It should therefore be reserved for patients presenting in good general condition with a low degree of cholecystitis.

Journal

Anz Journal of Surgery – Wiley

Published: Apr 1, 2005

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