Author(s): Martnez Ramos D, Daroca Jos JM, Escrig Sos J, Paiva Coronel G, Alcalde Snchez M,
Abstract Share this page
Abstract INTRODUCTION: Controversy remains about the management of gallstone ileus. While some authors propose enterotomy, others defend the one-stage procedure (simultaneously fistula repair). The objective of the present study was to analyze management options and comparative study their results. MATERIAL AND METHODS: Retrospective and descriptive study with revision of clinical stories of patients with the diagnosis of gallstone ileus between 1987 and 2008. All the following variables were recorded: dates of hospital admission, surgery and discharge, age, sex, pathological antecedents, preoperative or intraoperative diagnosis, treatment, location of the fistula and location of the obstruction. End-result variables were: postoperative complications, mortality, complications during the follow-up and biliary complications. RESULTS: A total of 40 patients were included of 46,648 admissions. Age, comorbidity, and intraoperative diagnosis were related with poorer short- and long-outcomes. The percentage of postoperative complications was similar for groups with and without fistula repair. Mortality was higher in the group with fistula repair (15 vs. 25\%). Biliary complications were more frequent in the group without fistula repair (11 vs. 0\%). Sex, location of the fistula and location of the obstruction did not be related with the prognosis. CONCLUSION: One-stage procedure is related with higher mortality rate than enterotomy alone. Nevertheless, fistula repair reduces the number of biliary complications during the follow-up.
This article was published in Rev Esp Enferm Dig
and referenced in Journal of Gerontology & Geriatric Research