[Gallstone ileus: plea for simultaneous treatment of obstruction and gallstone disease].
All patients with gallstone ileus admitted to our institution between 1985 and 1995, were retrospectively analysed, to determine, whether a one stage procedure (removal of impacted gallstone, fistula repair and cholecystectomy) is a more valid option than enterotomy. There were 10 patients (8 women, 2 men) in the study group (age range: 63-86 ans), representing 3.7% of small bowel obstruction and 1.4% of patients who underwent biliary surgery during the same period. Bowel occlusion was present in 8 patients and a correct preoperative diagnosis was made in only 2 cases (20%). Eight patients had a one-stage procedure, with no mortality but complications occurred in 2 cases. Enterotomy was the only surgical treatment in 2 cases, with no morbidity. During follow-up period, one patient died 3 years after enterotomy from a biliary complication. We believe that a one-step procedure, is a valid option and should be undertaken to prevent future recurrence, later biliary complications and reoperations in these elderly patients, who have serious concomitant diseases.
Sfairi
A
A
Service de Chirurgie Générale, Digestive et Vasculaire, Hôpital Ambroise Paré, Boulogne-Billancourt.
Patel
J C
JC
D000368:Aged; D000369:Aged, 80 and over; D001658:Biliary Fistula / Q000175:diagnosis / Q000601:surgery; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology / Q000601:surgery*; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome