Laparoscopic enterolithotomy for gallstone ileus.

BACKGROUND AND AIMS

Gallstone ileus (GSI) is an uncommon complication of gallstone disease that usually occurs in debilitated elderly patients in whom the minimal trauma of laparoscopic surgery might be advantageous. The outcome of laparoscopic surgery in 3 consecutive patients with GSI is presented, and its role is discussed.

METHODS

The laparoscopic approach was attempted in all patients with suspected GSI.

RESULTS

Three consecutive patients (2 female) aged 64 to 85 years with a median American Society of Anesthesiology score of 3E were admitted with small bowel obstruction. A laparoscopic enterolithotomy was carried out in all patients, and was completed successfully with a median operative time of 90 minutes. There were no intraoperative or postoperative complications, and the median postoperative hospital stay was 5 days.

CONCLUSIONS

Small bowel obstruction due to GSI may be safely managed using minimally invasive surgery with suggested benefits in these elderly patients.