Acta Med. 2022, 65: 153-157

Gallstone Ileus in Octogenarians: Is Cholecystectomy Really Needed?

Nikolaos Koliakosa, Dimitrios Papaconstantinoua, Andrianos Serafeim Tzortzisb, Efstratios Kofopoulos-Lymperisa, Anargyros Bakopoulosa, Konstantinos Nastosa, Evangelos P. Misiakosa, Emmanouil Pikoulisa

a3rd Department of Surgery, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
bMedical School, National and Kapodistrian University of Athens, Athens, Greece

Received November 24, 2021
Accepted December 8, 2022

Gallstone ileus is an uncommon complication of cholelithiasis and occurs when a gallstone migrates through a cholecystoenteric fistula and impacts within the gastrointestinal tract. Surgical intervention remains the treatment of choice, which consists of a full-thickness incision of the visceral wall and removal of the impacted gallstone. In this paper we present the treatment approach of 6 cases of gallstone ileus in octogenarians. In our cohort, intestinal obstruction was resolved through an enterotomy or gastrotomy and lithotomy/stone extraction in every patient. No cholecystectomies were undertaken. Despite the fact that gallstone ileus is diagnosed in small percent of patients suffering from gallstone disease, it accounts for a large proportion of intestine obstruction in patients older than 65 years old. Since accurate diagnosis and timely intervention are vital, providers should be familiar with the diagnostic approach and the treatment of this clinical entity.


11 live references