Rabie Mohamed A, Sokker Ashraf
General Surgery The Queen Elizabeth Hospital in Kings Lynn Kings Lynn UK.
General Surgery Ain Shams University Hospital Cairo Egypt.
Acute Med Surg. 2019 Mar 4;6(2):95-100. doi: 10.1002/ams2.404. eCollection 2019 Apr.
The incidence of gallstone ileus (GSI) is increasing. Current treatment options include enterolithotomy with or without cholecystectomy and repair of the biliodigestive fistula. Although most surgeons defer the management of the biliodigestive fistula to avoid the associated morbidity and mortality, this can lead to increased rate of recurrence of GSI by the remaining gallstones. More than 130 cases of recurrent GSI were reported in published works, and the incidence of recurrent GSI is reported to be between 5% and 20%. Some cases of second recurrent attacks have also been reported. Most cases were reported in elderly women with faceted stones during the first 2 months from the first episode of GSI. This article reviews the current treatment options for more than 4,300 reported cases of GSI. A treatment algorithm is recommended based on the severity of the inflammation around the gallbladder, including cholecystolithotomy as a third treatment approach that aims to reduce the risk of recurrent GSI.
胆石性肠梗阻（GSI）的发病率正在上升。目前的治疗选择包括行或不行胆囊切除术的肠石切除术以及胆肠瘘修补术。尽管大多数外科医生推迟对胆肠瘘的处理以避免相关的发病率和死亡率，但这可能会导致剩余胆结石引起的GSI复发率增加。已发表的文献报道了130多例复发性GSI病例，复发性GSI的发病率据报道在5%至20%之间。也有一些二次复发发作的病例报道。大多数病例报道见于老年女性，在GSI首次发作后的前2个月内出现多面形结石。本文回顾了超过4300例已报道的GSI病例的当前治疗选择。基于胆囊周围炎症的严重程度推荐了一种治疗算法，包括将胆囊结石切除术作为旨在降低复发性GSI风险的第三种治疗方法。
