Less is More: an Outcome Assessment of Patients Operated for Gallstone Ileus Without Fistula Treatment

Overview

Journal Int J Surg Case Rep

Specialty General Surgery

Date 2017 Jul 26

PMID 28743097

Citations 4

Authors

Dario Tartaglia

Sohail Bakkar

Lorenzo Piccini

Jessica Bronzoni

Luigi Cobuccio

Andrea Bertolucci

Christian Galatioto

Massimo Chiarugi

Affiliations

Soon will be listed here.

Abstract

Background: The treatment of gallstone ileus (GI) consists of surgical removal of the impacted bilestone with or without cholecystectomy and repair of the biliodigestive fistula. The objective of this study was to assess whether sparing patients a definitive biliary procedure adversely influenced the outcome.

Materials And Methods: Patients with a diagnosis of GI were reviewed. Two groups were identified: patients who underwent a definitive biliary procedure with relieving the intestinal obstruction (group 1/G1) and those who did not have a definitive biliary procedure (group 2/G2). In G2, patients were evaluated on long-term follow-up for the risk of recurrent GI disease, cholecystitis, cholangitis and gallbladder cancer.

Results: Among 1075 patients admitted for small bowel obstruction, 20 (1.9%) were diagnosed with gallstone ileus. 3 (15%) of these belong to G1, 17 (85%) to G2. The overall postoperative morbidity rate was 35% (7/20) with one complication exceeding grade II in each group. No deaths were reported. Mean follow-up was 50 months. During follow-up, one of G2 patients had recurrent disease. No biliary tract infections or gallbladder cancer were identified.

Conclusion: Enterolithotomy without fistula closure is confirmed to be safe and effective for the management of gallstone ileus both on a short- and long-term basis.

Citing Articles

Comparing outcomes of operative management of intestinal obstruction due to gallstone ileus using NSQIP database.

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Gallstone Ileus as an Infrequent Cause of Bowel Obstruction: A Review of Small Cohort.

Kumar S, Qavi Q, Bashir N, Alkistawi F, Lesi O, Sekaran P Cureus. 2024; 16(4):e58438.

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An emergency case of small bowel obstruction due to multiple gallstones in a limited resource setting.

Anwar S, Handoko H, Avanti W, Choridah L Int J Surg Case Rep. 2019; 63:104-107.

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Cholecystolithotomy, a new approach to reduce recurrent gallstone ileus.

Rabie M, Sokker A Acute Med Surg. 2019; 6(2):95-100.

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Stone in the distal jejunum presenting as small bowel obstruction: A case report.

Fatimah N, Ahmed A, Warraich M, Butt U, Ahmad Q, Ayyaz M Int J Surg Case Rep. 2018; 52:20-22.

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