van Hillo M, van der Vliet J A, Wiggers T, Obertop H, Terpstra O T, Greep J M
Surgery. 1987 Mar;101(3):273-6.
Ten patients with gallstone ileus were studied to evaluate diagnostic and therapeutic procedures. The preoperative diagnosis was correct in four patients. All patients underwent laparotomy. In five patients, stones were removed by enterotomy and in three patients the obstruction was relieved by manual propulsion of the stones. One-stage small-bowel resection, cholecystectomy, and biliary enteric fistula repair were performed in two patients. Four patients had uneventful recovery. One episode of recurrent gallstone ileus was encountered. Three patients died of septic complications. It is concluded from the study and from a review of the literature that treatment should be aimed at relieving the obstruction, without performing additional surgical procedures, such as cholecystectomy and fistula repair. Secondary biliary surgery is to be performed only in patients with recurrent biliary disease.
对10例胆石性肠梗阻患者进行了研究，以评估诊断和治疗方法。4例患者术前诊断正确。所有患者均接受了剖腹手术。5例患者通过肠切开术取出结石，3例患者通过手动推动结石缓解了梗阻。2例患者进行了一期小肠切除、胆囊切除和胆肠瘘修复。4例患者恢复顺利。发生了1次复发性胆石性肠梗阻。3例患者死于感染性并发症。从本研究及文献回顾得出结论，治疗应旨在解除梗阻，而不进行额外的外科手术，如胆囊切除和瘘修复。仅对复发性胆道疾病患者进行二期胆道手术。
