title: Gallstone ileus. A review of 39 cases with emphasis on surgical treatment.
abstract: A series of 39 cases of gallstone ileus is presented. The median follow-up period was 6 1/2 years (range 4 months-20 years). Surgical treatment was primarily performed in 36 cases. The overall operative mortality rate was 14%. In two cases the initial operation was one-stage enterolithotomy, fistula repair and cholecystectomy. In one of these cases a second operation had to be performed 18 months later, because of choledochal stones. Five of the 29 patients who survived initial simple removal of stone subsequently had biliary-duct related symptoms, all within the first three postoperative years. Re-operation was necessary in only three of these five cases (11% of the series). The study led to the conclusion that initial surgery for gallstone ileus should be limited to removal of obstructing stones. Recent literature, indicating increased mortality following one-stage repair, supports this conclusion.
mesh_terms: D000368:Aged; D002769:Cholelithiasis / Q000150:complications* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery; D007431:Intraoperative Complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality