Portal de Periódicos da CAPES

Gallstone ileus: management options and results on a series of 40 patients

2009; Arán Ediciones; Volume: 101; Issue: 2 Linguagem: Inglês

10.4321/s1130-01082009000200005

2340-4167

David Martínez Ramos, Jomine Jose, Javier Escrig Sos, G. Paiva Coronel, Miguel Alcalde Sánchez, José Sanchís,

Gastrointestinal disorders and treatments

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.