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. 2019 Apr-Jun;15(2):164-166.
doi: 10.4103/jmas.JMAS_88_18.

Laparoscopic two-stage procedure for gallstone ileus

Koichi Inukai  1 , Eri Tsuji  1 , Nobuhiro Takashima  1 , Minoru Yamamoto  1
Affiliations

Laparoscopic two-stage procedure for gallstone ileus

Koichi Inukai et al. J Minim Access Surg. 2019 Apr-Jun.

Abstract

Gallstone is a rare cause of bowel obstruction and is associated with high rates of morbidity and mortality. Here, we report a case of gallstone ileus treated by laparoscopic two-stage procedure. A 65-year-old man, without a history of any surgery, presented to our hospital with abdominal pain and vomiting. His abdominal computed tomography revealed gallstone ileus with cholecystoduodenal fistula. Then, enterolithotomy was performed as an emergency laparoscopic surgery. After 1 year of the surgery, a second laparoscopic procedure was performed for cholecystectomy and fistula closure. The patient was discharged on the 7th postoperative day. Laparoscopic two-stage procedure is a safe and an efficient approach for the management of gallstone ileus. This definitive treatment is minimally invasive, thereby suitable for treating elderly patients.

Keywords: Gallstone ileus; laparoscopic surgery; two-stage procedure.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Enhanced computed tomography showing intestinal obstruction in the pelvic area, with dilatation of the small intestine at the proximal side. A 5-cm round opacity (arrowheads) in the small intestine and pneumobilia (arrow) can be seen
Figure 2
Figure 2
By laparoscopic assistance, the gallstone was extracted using enterotomy
Figure 3
Figure 3
Laparoscopic surgery showing the cholecystoduodenal fistula. A tape was put through the dorsal side of the fistula
See this image and copyright information in PMC

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