Biliary ileus – a non-standard problem of emergency biliary surgery
DOI:
https://doi.org/10.11603/2414-4533.2026.2.16225Keywords:
gallstone disease, biliary ileus, diagnostics, surgical treatmentAbstract
The aim of the work: to evaluate the clinical outcomes of diagnosis and surgical management of biliary ileus, which will allow us to make a certain contribution to understanding, improving the results of diagnosis and treatment of the above pathology.
Matherials and Methods. The results of diagnosis and treatment of 23 patients with biliary ileus, which arose against the background of cholelithiasis and biliodigestive fistulas, were analyzed. There were 7 men (30.5 %), 16 women (69.55 %), aged from 58 to 82 years.
Results. The main method of diagnosing Bouveret syndrome is fibrogastroduodenoscopy, and for low-grade small bowel obstruction – computed tomography. All patients underwent surgery. In 2 patients with Bouveret syndrome (8.6 %), biliary ileus was eliminated by gastrotomy with removal of the stone after its movement into the stomach. In 18 patients with low small bowel obstruction (78.2 %), enterolithotomy was performed as the least traumatic surgical intervention. In one case (4.4 %) a single-stage intervention was performed (enterolithotomy, cholecystectomy, fistula elimination), in another (4.4 %) – enterolithotomy with cholecystostomy, and in another one (4.4 %) – hybrid enterolithotomy. One patient died in the postoperative period with an overall mortality of 4.4 %.
Conclusions. In the surgical treatment of biliary ileus, preference should be given to minimal surgical interventions in the form of enterolithotomy. However, the tactics of definitive surgical treatment of biliary ileus should be individualized with the choice of the optimal surgical approach.
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