Assali Sarah, Mourany John, Jones Brendan, Dudas Lauren, Szoka Nova
Allegheny Health Network, USA.
West Virginia University, USA.
Case Rep Surg. 2020 Oct 10;2020:8852804. doi: 10.1155/2020/8852804. eCollection 2020.
Gallstone ileus is an infrequent cause of small bowel obstructions (SBO), accounting for only 0.1-5% of SBOs and 25% of nonstrangulating causes of SBO in the elderly population. There is scant literature available regarding the use of laparoscopy to treat gallstone ileus. Currently, much of the literature available is limited to case reports only.
A complete laparoscopic approach was utilized to manage a 65-year-old woman with morbid obesity who presented with gallstone ileus. With regard to our technical approach, we describe the technical approach that facilitates safe laparoscopic examination of the entire small bowel and can be applied to other acute care surgery cases involving small bowel pathology.
The patient's postoperative course was complicated by new-onset atrial fibrillation which was treated medically with good response. She was safely discharged on postoperative day 2.
Laparoscopy is a feasible option for the management of gallstone ileus and can lead to decreased morbidity compared to laparotomy. The technique described allows for laparoscopic examination of the entire small bowel.
胆结石性肠梗阻是小肠梗阻（SBO）的一种罕见病因，仅占SBO的0.1 - 5%，在老年人群中占非绞窄性SBO病因的25%。关于使用腹腔镜治疗胆结石性肠梗阻的文献很少。目前，现有文献大多仅限于病例报告。
采用完全腹腔镜方法治疗一名65岁的病态肥胖女性胆结石性肠梗阻患者。关于我们的技术方法，我们描述了有助于安全地对整个小肠进行腹腔镜检查的技术方法，该方法可应用于涉及小肠病变的其他急性护理手术病例。
患者术后病程因新发房颤而复杂化，经药物治疗反应良好。她于术后第2天安全出院。
腹腔镜检查是治疗胆结石性肠梗阻的一种可行选择，与开腹手术相比可降低发病率。所描述的技术允许对整个小肠进行腹腔镜检查。
