Porelli P, Mastroianni V, Della Beffa V, Bonini A, Giustetto A, Iseri P, Bevilacqua S
Minerva Chir. 1989 Apr 15;44(7):1089-94.
A critical review of the world literature of the main authors in the past twenty years (871 cases) and the personal series (1975-1987: 22 cases) shows that biliary ileus is a rare, serious pathology with an emergency surgical indication. The numerical data collected confirm the need for a conservative surgical attitude, limited to the removal of the obstructing cause. Some authors have maintained that it is possible to treat the occlusion and the bilio-digestive fistula and carry out the cholecystectomy contemporaneously. Personally it is considered that the latter possibility can be confined to carefully selected patients who are not too elderly, do not present associated pathologies and for whom the diagnostic opinion is one of preoperative biliary ileus. Cholecystectomy is therefore programmed and this is followed at a later stage by repair of the biliary fistula, the occlusive pathology being corrected immediately so as to eliminate as far as possible the immediate risks of prolonged emergency surgery on the bile ways and digestive tract at the same time.
对过去二十年主要作者的世界文献（871例）以及个人病例系列（1975 - 1987年：22例）进行的批判性综述表明，胆石性肠梗阻是一种罕见且严重的病理状况，具有紧急手术指征。收集到的数据证实需要采取保守的手术态度，仅限于去除梗阻原因。一些作者认为，可以治疗梗阻和胆肠瘘，并同时进行胆囊切除术。就个人而言，认为后一种可能性仅限于精心挑选的患者，这些患者年龄不过大，没有合并其他病理状况，且诊断意见为术前胆石性肠梗阻。因此安排进行胆囊切除术，随后在后期修复胆瘘，立即纠正梗阻性病变，以便尽可能消除对胆道和消化道同时进行长时间急诊手术带来的直接风险。
