Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Apr 2;17(4):e81631.
doi: 10.7759/cureus.81631. eCollection 2025 Apr.

Post-cholecystectomy Gallstone Ileus: A Narrative Review

Ahmed Taha  1 , Natalie Hassan  2
Affiliations
Review

Post-cholecystectomy Gallstone Ileus: A Narrative Review

Ahmed Taha et al. Cureus. .

Abstract

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.

Keywords: bowel obstruction; dropped gallstone; gallstone ileus; gallstone ileus post-cholecystectomy; gallstones; pneumobilia; post-cholecystectomy; rigler´s triad.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Aetiologies of gallstones in PCGSI among the 26 case reports identified within this paper.
Figure 2
Figure 2. Prevalence of pneumobilia and its associated aetiologies among the 26 case reports identified within this paper.
See this image and copyright information in PMC

References

    1. Surgery for gallstone ileus: a nationwide comparison of trends and outcomes. Halabi WJ, Kang CY, Ketana N, et al. Ann Surg. 2014;259:329–335. - PubMed
    1. Gallstone ileus: a review of 1001 reported cases. Reisner RM, Cohen JR. https://pubmed.ncbi.nlm.nih.gov/8198337/ Am Surg. 1994;60:441–446. - PubMed
    1. Post-cholecystectomy gallstone ileus. Meier J, Guzzetta AA, Huerta S. Am Surg. 2020;86:675–684. - PubMed
    1. Gallstone ileus in the absence of cholecystoduodenal fistula. Inglott F, Williamson RC. HPB. 2000;2:61–63.
    1. Jejunal limb obstruction caused by a cholesterol stone 15 years after a total gastrectomy and 20 years after a cholecystectomy: report of a case. Wada N, Seki M, Saikawa Y, et al. Surg Today. 2000;30:181–184. - PubMed

LinkOut - more resources