Laparoscopically assisted enterolithotomy for a gallstone ileus in an atypical location

Lichten, Jason; Tehrani, K.; Sekons, David H.

doi:10.1007/s00464-002-4540-7

Cited by 10 publications

(5 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is in accordance with other authors [7]. However, there are also discrepancies in the literature and some authors describe the ileocaecal valve as the most frequent site of stone impaction [8].…”

Section: Discussionsupporting

confidence: 72%

“…A laparoscopically-assisted approach is also discussed with all its possible advantages [8]. Diagnostic laparoscopy is helpful in patients with diagnostic uncertainty and the site, too, for eventual laparotomy may be optimised.…”

Section: Discussionmentioning

confidence: 99%

“…Diagnostic laparoscopy is helpful in patients with diagnostic uncertainty and the site, too, for eventual laparotomy may be optimised. On the other hand, precise exploration of the whole small intestine is more difficult and multiple stones can be missed [8].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Gallstone ileus – a rare disease and still many discrepancies

Šimša

Leffler

et al. 2006

Eur Surg

View full text Add to dashboard Cite

Zusammenfassung. Grundlagen: Gallensteinileus ist eine seltene Krankheit. Eine genaue Diagnose wird nur selten vor dem chirurgischen Eingriff durchgeführt. Optimale Heilungsstrategie, Indikation der Cholezystektomie und Behandlung der biliaren Fistel bleiben umstritten.Methodik: Es wurden eine retrospektive Studie und Datenanalyse der Patienten, die wegen eines Gallensteinileus an der chirurgischen Abteilung des Universitäts-krankenhauses Motol innerhalb der letzten 16 Jahre (1. Januar 1989 -31. Dezember 2004) operiert wurden, durchgeführt.Ergebnisse: Die untersuchte Gruppe bestand aus 23 Patienten -18 Frauen (78,3 %) im Durchschnittsalter von 76,5 Jahren und 5 Männer (21,7 %) im Durchschnittsalter von 76,9 Jahren. Die Enterolithotomie wurde bei 19 Patienten (82,7 %) durchgeführt. Die Sterblichkeit war hoch, die häufigsten aufgetretenen Probleme, die bei 10 Patienten (43,5 %) vorkamen, betrafen die Wundenheilung. Die Sterblichkeitsrate betrug 8,7 %. Weitere biliare Symptome wurden nur bei 3 Patienten (13 %) beobachtet. Alle waren mit herkömmlichen Steinen in den Gallenröhren verbunden.Schlussfolgerungen: Ziel der optimalen Behandlung ist die rechtzeitige Diagnose und prompte Entfernung der Dünndarmobstruktion. Die Entherolithotomie scheint Methode der Wahl bei akutem chirurgischem Eingriff zu sein. Multiple Steine können bei bis zu 20 % der Patienten vorkommen und sollten nicht übersehen werden. Man sollte eine Cholezystektomie nur bei Patienten in gutem gesundheitlichem Zustand und mit bestehenden biliaren Symptomen und Cholezystolithiasis erwägen.

show abstract

Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gallstone ileus – a rare disease and still many discrepancies

Šimša

Leffler

et al. 2006

Eur Surg

View full text Add to dashboard Cite

show abstract

“…With the advent of laparoscopic surgery, laparoscopically assisted or even total laparoscopic enterolithotomies have been reported with satisfactory results. [10][11][12][13][14][15] The major morbidity of conventional open enterolithotomy is related to wound complications. 1 Laparoscopically assisted enterolithotomy can significantly decrease the wound size.…”

Section: Discussionmentioning

confidence: 99%

Migrating Gallstone: From Bouveret's Syndrome to Distal Small Bowel Obstruction

Yau¹,

Siu²,

Tsui³

2006

Journal of Laparoendoscopic & Advanced Surgical Techniques

View full text Add to dashboard Cite

Gallstone ileus is an uncommon cause of small bowel obstruction. When the gallstone lodges inside the duodenum and causes gastric outlet obstruction, it is termed Bouveret's syndrome. However, it is rather unusual to seen the evolution of a migrating gallstone (from duodenum to distal small bowel) in a patient during the same hospital admission. We report a case of gallstone ileus from the initial presentation of gastric outlet obstruction to the development of distal small bowel obstruction within the same hospital admission, and its total laparoscopic treatment.

show abstract

“…8 Surgery is the treatment of choice, with 2 possible approaches: enterolithotomy alone through laparotomy or laparoscopy, which is advised especially in elderly patients with associated comorbidities. 9 The 1-stage procedure on the other side includes enterolithotomy, cholecystectomy, and fistula repair and offers a definitive management in avoiding another operation but is accompanied by higher mortality rates. There is no consensus on the choice of operation.…”

mentioning

confidence: 99%

Image of the Month—Diagnosis

2011

Arch Surg

View full text Add to dashboard Cite

C omputed tomographic scans revealed a mechanical ileus with a distended jejunum and proximal ileum. In particular, a cockade in the distal small bowel and a large diverticulum of the duodenum were depicted on computed tomographic scans. The patient was taken to the operating room and a short median laparotomy was performed. The origin of the mechanical ileus was a large gallstone (45ϫ25ϫ 20 mm) 70 cm distal to the ligament of Treitz. Segmental bowel resection was performed. The patient was discharged a few days later after an uneventful recovery. This case describes a gallstone ileus in the absence of the gallbladder. The site of stone formation was probably a large diverticulum of the duodenum. This duodenal diverticulum most likely originated from the base of the distal common bile duct next to the head of the pancreas (Figure 2). Stone formation in the common bile duct seems unlikely in light of the volume of the gallstone and unremarkable biliary tract. Gallstone ileus is a rare disease that typically occurs in elderly individuals and is associated with high mortality rates up to 18%. 1,2 Intraluminal impaction of gallstones in the intestinal tract usually occurs as a result of recurrent cholecystitis leading to penetration of a gallstone through a biliodigestive fistula. In 15% to 20% of cases, the gallstones reach the intestinal tract in a natural way. 3 The most common site of stone impaction is the terminal ileum and ileocecal valve and, to a lesser extent, in the jejunum and stomach, while the duodenum and colon are rare locations. 2,4,5 Stone impaction at the

show abstract

Laparoscopically assisted enterolithotomy for a gallstone ileus in an atypical location

Cited by 10 publications

References 3 publications

Gallstone ileus – a rare disease and still many discrepancies

Gallstone ileus – a rare disease and still many discrepancies

Migrating Gallstone: From Bouveret's Syndrome to Distal Small Bowel Obstruction

Image of the Month—Diagnosis

Contact Info

Product

Resources

About