Gallstone ileus. Review of 112 patients in the Japanese literature.

A survey was made of 112 cases of gallstone ileus reported in the Japanese literature, including 3 of our cases. The ratio of males to females was 1 to 1.1, the age range was 13 to 87 years, and biliary-enteric fistulas were demonstrated in 81 percent of the patients. Although cholecystoduodenal fistula was most common, eight cases of choledochoduodenal fistula were reported. Sixteen patients passed obstructing gallstones through a patulous sphincter of Oddi. The ileum was occluded in 54 percent of the cases. Duodenal obstruction was seen in 10 percent. There was no operative mortality in seven patients treated with enterolithotomy, subsequent cholecystectomy and repair of the fistula, whereas a mortality rate of 19 percent followed the one-stage procedure.