Laparoscopically assisted or open enterolithotomy for gallstone ileus.
BACKGROUND
Gallstone ileus is associated with high morbidity and mortality rates. Enterolithotomy as a single procedure is recommended to minimize complications. The trauma could potentially be reduced further by using a laparoscopic technique.


METHODS
Thirty-two consecutive patients with gallstone ileus operated by a laparoscopic or open approach between 1992 and 2004 were studied retrospectively. Demographic data, preoperative and postoperative hospital stay, duration of operation, complications and deaths were recorded. Median follow-up after surgery was 36 months.


RESULTS
Nineteen laparoscopic procedures, with two conversions, and 13 open operations were performed. The median duration of operation was 60 min in the laparoscopic group and 58 min in the open group (P = 0.675). The median hospital stay was 7 and 10 days, respectively (P = 0.383). There were five minor and one major complications in the laparoscopic group, compared with one and four, respectively, in the open group. There were no deaths within 30 days.


CONCLUSIONS
The overall morbidity rate was low after both laparoscopic and open enterolithotomy for gallstone ileus, especially in terms of major complications in the laparoscopic group. Laparoscopically assisted enterolithotomy can be recommended for both diagnosis and treatment.
Moberg
A-C
AC
Department of Surgery, Malmö University Hospital, S-20502 Malmö, Sweden. ann-cathrin.moberg@skane.se
Montgomery
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome