Introduction. Gallstone ileus is an uncommon mechanical bowel obstruction caused by a gallstone in the gastrointestinal tract which enters due to bile-enteric fistulae. This study aims to describe gallstone ileus and its management. Method. Data were retrospectively collected from medical records. Clinical manifestations, laboratory data, supporting radiographic examinations, treatment, postoperative care, and outcomes were collected. Results. We report two gallstone ileus cases at Cipto Mangunkusumo General Hospital, Jakarta which admitted in the last 20 years. The first case was a woman 33 years in 2002 and the second was man 45 years in 2017. Ileus was the main clinical symptoms. Gallstone ileus was diagnosed with preoperatively based on clinical and radiology findings. Laparotomy was performed and ileostomy for stones evacuation and cholecystectomy were performed without bile-enteric fistula repair. Large black stones were found at terminal ileum which made the obstruction. Conclusion. Gallstone ileus was an uncommon disease which can be treated and has a good prognosis. Plain abdominal x-ray has an important role in diagnosis and treatment approach.

Background: Identification of hepatic vascular anatomy and intrahepatic bile duct (IHD) variation is essential before performing living donor liver transplantation. This study aimed to describe and classify the anatomic variation of liver donors in Indonesia. Methods: We identified 75 liver donors at Dr. Cipto Mangungkusumo Hospital between 2010 and 2022. All of them were examined using computed tomography angiography (CTA), but only 51 subjects had magnetic resonance (MR) and intraoperative cholangiogram (IOC) documentation due to missing data. We classified the hepatic artery according to Michel's classification, portal vein based on Nakamura's classification, and IHD using Huang's classification. Results: The mean age was 31.7 ± 6.1 years, dominated by 58.7% females. The mean duration of surgery was 429.4 ± 109.7 minutes. Michel's artery classification consisted of type I (57, 76.0%), II (4, 5.3%), III (5, 6.7%), VI (3, 4.0%), and type IV, V, IX (2, 2.7%) each. Nakamura's portal vein classification consisted of type A (67, 89.3%), B (5, 6.7%), and C (3, 4.0%). The hepatic vein consisted of left & middle hepatic vein common trunk (45, 60.0%), independent drainage (13, 17.3%), and others (17, 227%). Meanwhile, IHD classification consisted of Huang A1 (29, 59.2%), Huang A2 (8, 16.3%), Huang A3 (6, 12.2%), Huang A4 (5, 10.2%), and Huang A5 (1, 2.1%). Conclusions: Preoperative MRC and CTA are beneficial examinations for hepatic vascular and biliary tract mapping before performing liver resection to improve the operative duration and prevent postoperative complications.

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