Comparison between surgical techniques in gallstone ileus and outcomes.

INTRODUCTION

Gallstone ileus is a rare cause of mechanical bowel obstruction, generally found in elderly patients who often have other significant medical conditions.

OBJECTIVE

The objective of the study was to determine the prevalence of gallstone ileus and the number of postsurgical complications and outcomes depending on what type of surgical management is performed.

METHOD: Cohort, retrospective, observational, and comparative study was conducted, which included 31 patients undergoing surgery for gallstone ileus. Three groups were integrated according to the type of surgical procedure: Group 1: enterotomy and stone extraction alone,. Group 2: enterotomy and cholecystectomy with fistula closure, and Group 3: bowel resection alone.

RESULTS

A total of 31 patients were analyzed. Gallstone ileus represented the 1.44% of all cases of bowel obstruction. Complication rates were similar between three groups. Mortality rate was lower in Group A, especially when compared to Group B, with a statistically significant difference (p < 0.05).

CONCLUSIONS

Surgery is the pillar in treatment of gallstone ileus. Enterotomy with stone extraction alone appears to be associated with a lower mortality rate and better outcomes when compared to more extensive techniques.