Deitz D M, Standage B A, Pinson C W, McConnell D B, Krippaehne W W
Am J Surg. 1986 May;151(5):572-6. doi: 10.1016/0002-9610(86)90550-7.
A 32 year retrospective review of 24 cases of gallstone ileus from the hospitals of Oregon Health Sciences University has been presented. Nineteen patients (79 percent) were female and 18 (75 percent) were more than 70 years of age. Fifty-four percent of the patients had a correct preoperative diagnosis that correlated well with the roentgenographic findings. Enterolithotomy was the most frequently employed operation, and cholecystoduodenal fistulas were positively identified in 61 percent of the patients. Most obstructions occurred in the distal ileum (48 percent). Wound infections occurred in six patients (26 percent), and there were three deaths for a mortality rate of 13 percent. Of note, the incidence of wound infections and mortality is found to be decreasing. This is related to the more frequent use of prophylactic antibiotics. The controversy regarding performing an enterolithotomy alone versus a one stage procedure has been reviewed and several interesting and atypical cases have been briefly discussed.
本文对俄勒冈健康科学大学附属医院24例胆石性肠梗阻患者进行了为期32年的回顾性研究。19例患者（79%）为女性，18例（75%）年龄超过70岁。54%的患者术前诊断正确，与影像学检查结果相符。肠切开取石术是最常用的手术方式，61%的患者被明确诊断为胆囊十二指肠瘘。大多数梗阻发生在回肠末端（48%）。6例患者（26%）发生伤口感染，3例死亡，死亡率为13%。值得注意的是，伤口感染和死亡率呈下降趋势。这与预防性抗生素的更频繁使用有关。本文回顾了关于单纯行肠切开取石术与一期手术的争议，并简要讨论了几例有趣的非典型病例。
