Brezean I, Aldoescu S, Catrina E, Fetche N, Marin I, Păcescu E
Department of Surgery, Dr. I. Cantacuzino Clinical Hospital, Bucharest, Romania.
Chirurgia (Bucur). 2010 May-Jun;105(3):355-9.
We hereby analyzed a series of gallstone ileus cases operated on in our department starting from a Bouveret syndrome case.
Retrospective analysis of all gallstone ileus cases who underwent surgery in our department during the last 26 years. We took into consideration diagnostic elements, time from admission to surgery, type of surgery and post-operative outcome.
During this period 9,143 gallstones were deferred to surgery; 27 biliary-digestive fistulae were discovered during surgery; gallstone ileus complicated fistula in 8 patients. Gallstone ileus was exclusively present in elderly women with associated comorbidities. Diagnosis was suggested by clinical features of acute or incomplete intestinal obstruction; it was sustained by imagistic studies with different degrees of relevance. The average time from admission to surgery was 2.6 days. Surgical approach varied from simple enterolithotomy to additional fistula repair. The outcome was uneventful in most of the cases with only one exception.
gallstone ileus is a rare condition, occurring in elders with important comorbidities. The choice for surgical procedure depends on the obstructive syndrome's gravity and associated comorbidities; the type of intervention does not significantly influence post-operative morbidity and mortality rates.
我们从一例布维耶综合征病例开始，分析了本科室手术治疗的一系列胆石性肠梗阻病例。
回顾性分析过去26年在本科室接受手术的所有胆石性肠梗阻病例。我们考虑了诊断因素、入院至手术的时间、手术类型和术后结果。
在此期间，9143例胆结石患者接受了手术；术中发现27例胆肠瘘；8例胆石性肠梗阻合并瘘管。胆石性肠梗阻仅见于患有合并症的老年女性。急性或不完全性肠梗阻的临床特征提示了诊断；影像学检查在不同程度上支持了诊断。入院至手术的平均时间为2.6天。手术方式从单纯肠石切除术到额外的瘘管修复不等。大多数病例预后良好，仅1例例外。
胆石性肠梗阻是一种罕见疾病，发生于患有严重合并症的老年人。手术方式的选择取决于梗阻综合征的严重程度和相关合并症；干预类型对术后发病率和死亡率没有显著影响。
