Taha Ahmed, Hassan Natalie
General Surgery, Nottingham University Hospitals NHS Trust, Nottingham, GBR.
Plastic Surgery, University Hospitals of North Midlands NHS Trust, West Midlands, GBR.
Cureus. 2025 Apr 2;17(4):e81631. doi: 10.7759/cureus.81631. eCollection 2025 Apr.
Gallstone ileus (GSI) is a rare cause of mechanical obstruction, caused by a gallstone that enters the gastrointestinal tract typically via a cholecystoduodenal fistula. Post-cholecystectomy gallstone ileus (PCGSI) is a specific subset occurring in patients who have previously undergone cholecystectomy. This paper aims to explore the characteristics and proposed aetiologies of PCGSI through a comprehensive narrative review of 26 case reports published between 2000 and 2024. The mechanisms leading to PCGSI are categorized into several aetiologies: bilioenteric fistulas, transpapillary gallstones, lost stones during cholecystectomy, and reconstructive surgery-associated gallstones. The findings underscore that while PCGSI shares similarities with GSI, it can present unique challenges due to its varied aetiologies, leading to misdiagnosis and consequent delays in treatment. The study emphasizes the importance of accurate imaging techniques, particularly CT scans, for effective diagnosis and highlights the need for awareness among clinicians regarding this rare condition's presentation and underlying mechanisms.
胆石性肠梗阻（GSI）是机械性肠梗阻的一种罕见病因，由胆结石通常经胆囊十二指肠瘘进入胃肠道所致。胆囊切除术后胆石性肠梗阻（PCGSI）是发生在既往接受过胆囊切除术患者中的一种特定类型。本文旨在通过对2000年至2024年间发表的26例病例报告进行全面的叙述性综述，探讨PCGSI的特征及推测病因。导致PCGSI的机制可分为几种病因：胆肠瘘、经乳头胆结石、胆囊切除术中结石遗留以及重建手术相关胆结石。研究结果强调，虽然PCGSI与GSI有相似之处，但由于其病因多样，可能带来独特的挑战，导致误诊及随之而来的治疗延误。该研究强调了准确的成像技术，尤其是CT扫描对有效诊断的重要性，并突出了临床医生对这种罕见疾病的表现及潜在机制提高认识的必要性。
