Gallstone ileus: management options and results on a series of 40 patients

Autor: JL Salvador Sanchís, G. Paiva Coronel, J. M. Daroca José, M. Alcalde Sánchez, D. Martínez Ramos, J Escrig Sos
Rok vydání: 2009
Předmět:
Zdroj: Revista Española de Enfermedades Digestivas v.101 n.2 2009
SciELO España. Revistas Científicas Españolas de Ciencias de la Salud
instname
ISSN: 1130-0108
Popis: Introduction: controversy remains about the management of gallstone ileus. While some authors propose enterotomy, others defend the one-stage procedure (simultaneously fistula repair). The objective of the present study was to analyze management options and comparative study their results. Material and methods: retrospective and descriptive study with revision of clinical stories of patients with the diagnosis of gallstone ileus between 1987 and 2008. All the following vari ables were recorded: dates of hospital admission, surgery and dis charge, age, sex, pathological antecedents, preoperative or intra operative diagnosis, treatment, location of the fistula and location of the obstruction. End-result variables were: postoperative com plications, mortality, complications during the follow-up and bil iary complications. Results: a total of 40 patients were included of 46,648 ad missions. Age, comorbidity, and intraoperative diagnosis were re lated with poorer short- and long-outcomes. The percentage of postoperative complications was similar for groups with and with out fistula repair. Mortality was higher in the group with fistula re pair (15 vs. 25%). Biliary complications were more frequent in the group without fistula repair (11 vs. 0%). Sex, location of the fistu la and location of the obstruction did not be related with the prog nosis. Conclusion: one-stage procedure is related with higher mor tality rate than enterotomy alone. Nevertheless, fistula repair re duces the number of biliary complications during the follow-up.
Databáze: OpenAIRE