Laparoscopic management of sigmoid colon gallstone ileus
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Gallstone ileus is an uncommon clinical presentation of complicated biliary lithiasis that mostly occurs in the elderly without specific signs. Various types of surgical management have been proposed: primary enterolithotomy, enterolithotomy, cholecystectomy and fistula closure (one stage), or enterolithotomy with delayed cholecystectomy (two stage). All are associated with a high complication rate. We present a video of a laparoscopic cololithotomy for gallstone ileus caused by a gallstone impacted in the sigmoid colon. As a safe and feasible procedure, enterolithotomy appears to be the treatment of choice based on the scientific literature, especially in frail patients. However, except in case of an impacted gallstone in a colorectal cancer, colon resection is not mandatory. Further surgery (such as cholecystectomy or colectomy in benign disease such as diverticulosis) may be selectively considered.
KeywordsGallstones Laparoscopy Ileus
Compliance with ethical standards
Conflict of interest
CF, DF, PW, and AZLB have no conflict of interest considering this manuscript.
All procedures in studies involving human participants were in accordance with the ethical standards of the local research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent to publication of the video and images in this article was obtained from the concerned patient.