Introduction: Gallstone ileus is a rare complication of cholelithiasis whose mainstay treatment is surgery1. However, there is no consensus about its most appropriate surgical strategy2. The objective of this study is to define whether a conservative surgical strategy could be considered adequate treatment for this condition Material and methods: The records of 19 patients with a diagnosis of gallstone ileus during the period 2005-2016 were reviewed. Data collected included: patient demographics, the type of surgery performed, operative time, and postoperative morbidity and mortality rates. Based on the surgical strategy undertaken, patients were divided into two groups: group 1 (G1) included those who had a definitive biliary procedure, and group 2 (G2) included those in which surgery was limited to the treatment of the intestinal obstruction. In G2, disease recurrence and the subsequent need to re-operate, and the risk of developing gallbladder carcinoma were evaluated Results: There were 13 females and 6 males, with an average age of 84 years. G2 included 84% (16/19) of the patients. The mean operative time was significantly shorter in G2 (97 vs. 228 minutes; pvalue = 0.0003). The overall postoperative morbidity rate was 37% (7/19), and was higher for G1: 67% (2/3) vs. 31% (5/16). However, the difference was not statistically significant (p-value= 0.52). No mortalities were reported. Upon follow-up, none of G2 patients had recurrent disease or developed gallbladder cancer Conclusion: A conservative surgical approach to gallstone ileus seems to be sufficient in elderly patients with co-morbidities that would benefit from a considerably shorter operative time and less extensive surgery References: 1. Clavien PA, Richon J, Burgan S, Rohner A. Gallstone Ileus. Br J Surg. 1990;77:737-742. 2. Kirchmayr W, Mu¨hlmann G, Zitt M, Bodner J, Weiss H, Klaus A. Gallstone ileus: rare and still controversial. ANZ J Surg. 2005;75:234- 238 Disclosure: No significant relationships.
A CONSERVATIVE SURGICAL APPROACH TO GALLSTONE ILEUS: AN OUTCOME ASSESSMENT
TARTAGLIA, DARIO;BAKKAR, SOHAIL YOUSEF HUSSAIN;BRONZONI, JESSICA;PICCINI, LORENZO;COBUCCIO, LUIGI;BERTOLUCCI, ANDREA;GALATIOTO, CHRISTIAN;CHIARUGI, MASSIMO
2017-01-01
Abstract
Introduction: Gallstone ileus is a rare complication of cholelithiasis whose mainstay treatment is surgery1. However, there is no consensus about its most appropriate surgical strategy2. The objective of this study is to define whether a conservative surgical strategy could be considered adequate treatment for this condition Material and methods: The records of 19 patients with a diagnosis of gallstone ileus during the period 2005-2016 were reviewed. Data collected included: patient demographics, the type of surgery performed, operative time, and postoperative morbidity and mortality rates. Based on the surgical strategy undertaken, patients were divided into two groups: group 1 (G1) included those who had a definitive biliary procedure, and group 2 (G2) included those in which surgery was limited to the treatment of the intestinal obstruction. In G2, disease recurrence and the subsequent need to re-operate, and the risk of developing gallbladder carcinoma were evaluated Results: There were 13 females and 6 males, with an average age of 84 years. G2 included 84% (16/19) of the patients. The mean operative time was significantly shorter in G2 (97 vs. 228 minutes; pvalue = 0.0003). The overall postoperative morbidity rate was 37% (7/19), and was higher for G1: 67% (2/3) vs. 31% (5/16). However, the difference was not statistically significant (p-value= 0.52). No mortalities were reported. Upon follow-up, none of G2 patients had recurrent disease or developed gallbladder cancer Conclusion: A conservative surgical approach to gallstone ileus seems to be sufficient in elderly patients with co-morbidities that would benefit from a considerably shorter operative time and less extensive surgery References: 1. Clavien PA, Richon J, Burgan S, Rohner A. Gallstone Ileus. Br J Surg. 1990;77:737-742. 2. Kirchmayr W, Mu¨hlmann G, Zitt M, Bodner J, Weiss H, Klaus A. Gallstone ileus: rare and still controversial. ANZ J Surg. 2005;75:234- 238 Disclosure: No significant relationships.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
