ADVANTAGES OF ONE-STAGE REPAIR IN CASE OF GALLSTONE ILEUS

Background/Aims: The commonly used procedure to treat gallstone ileus is enterolithotomy in combination with late cholecystectomy for persis tent symptoms. It is related to a high mortality rate up to 20%. To da te it has been impossible to reduce the mortality associated with this accepted surgical technique. Patients and Methods: A seven-year retro spective study with a follow up over a period of four years and five m onths. Sixteen patients with gallstone ileus were entered into the stu dy. Twelve patients were female and fourteen were more than 70 years o f age. Fourteen patients were treated by enterolithotomy as well as ad ditional cholecystectomy and resection. of the fistula in a one-stage repair. Results: Mortality during hospitalization amounted to one (6%) and postoperative complications to five patients (31%). Follow-up ove r a period of four years and five months showed one patient had died 3 years postoperatively of an advanced renal tumor. All other patients were alive and without symptoms. Conclusion: Our results prove that th e concomitant one-stage repair for gallstone ileus significantly reduc es the overall mortality rate compared to the single enterolithotomy a lone and Later cholecystectomy based on. patient symptoms.