Gallstone Ileus: Laparoscopic-Assisted Enterolithotomy

Abstract

Although longevity in Western countries has probably increased the prevalence of gallstone ileus,1 this disorder remains a rare, often unrecognized, cause of gastrointestinal mechanical obstruction, accountable for no more than 4% of cases.1-3 The advanced age of the patients, the frequent concomitant presence of severe medical diseases, and the delay before surgical treatment contribute to high morbidity and mortality rates, ranging from 11 to 75% and from 8 to 20%, respectively.2,4 Although consensus has not been reached as to the emergency surgical procedure for gallstone ileus, especially regarding the timeliness and timing of biliary surgery,5 a simple enterolithotomy is considered to be the procedure of choice by most authors.1,2,6 To optimize results, the operation should be expeditious and surgical trauma kept to a minimum. We use the videolaparoscopic approach, described here, in the treatment of three cases of gallstone ileus.