title: [Surgical management of gallstone ileus: fourteen year experience].
abstract: OBJECTIVE
  The aim of this study is to describe our experience in the diagnosis and treatment of gallstone ileus, as well as the morbility and mortality associated to this pathology.
  
  
  BACKGROUND
  The first description of gallstone ileus was made by Bartholin in 1645 during a post-mortem study. It is a rare pathology, the preoperative diagnosis is difficult and controversy exists in the management that should be carried out on first instance, whether the extraction of the gallstone or the correction of the fistula which can affect outcome.
  
  
  METHODS
  We made a case series study in which we studied a total of 25 patients in a 14 years period (1989-2003) with diagnosis of gallstone ileus, patients excluded were those with cholecystoduodenal fistula without gallstone ileus. The variables analyzed were: age, sex, preoperative and postoperative diagnosis, treatment and postoperative morbidity and mortality.
  
  
  RESULTS
  Twenty, five patients were studied with diagnosis of gallstone ileus (20 women and 5 men) The median age was 64 (rage 41 to 99). The cholecystoenteric fistula is the most frequently was the cholecystoduodenal in 23. cases (92%) one coledocoduodenal (4%) and one cholecystogastric (4%). The most common site of obstruction was the terminal ileon in 96%. There was a morbility of 20% and the mortality in 7%.
  
  
  CONCLUSIONS
  Gallstone ileus is a rare entity, with only 25 cases reported in a 14 years period in our hospitals. Initial surgical treatment should be guided to the correction of the obstruction and should be considered in a second stage the correction of the fistula, if the patient does not develop symptoms it is not necessary, decreasing morbidity and mortality.
authors.affiliation: Hospital Regional lo. de Octubre, ISSSTE, Mexico, D.F. amondra1@prodigy.net.mx
authors.forename: Alejandro
authors.initials: A
authors.lastname: Mondragón Sánchez
authors.forename: Guillermo
authors.initials: G
authors.lastname: Berrones Stringel
authors.forename: Alejandro
authors.initials: A
authors.lastname: Tort Martínez
authors.forename: Carlos
authors.initials: C
authors.lastname: Soberanes Fernández
authors.forename: Leticia
authors.initials: L
authors.lastname: Domínguez Camacho
authors.forename: Ricardo
authors.initials: R
authors.lastname: Mondragón Sánchez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006801:Humans; D045823:Ileus / Q000150:complications / Q000601:surgery*; D007412:Intestinal Fistula / Q000150:complications; D008297:Male; D008875:Middle Aged