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Laparoscopic management of sigmoid colon gallstone ileus

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Abstract

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.

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References

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Authors and Affiliations

  1. Department of Digestive Disease, Mutualiste Montsouris Institute, Paris, France

    Carlotta Ferretti & David Fuks

  2. Paris Descartes University, Paris, France

    David Fuks

  3. Department of Digestive Surgery and Surgical Oncology, Avicenne Hospital, University of Paris XIII, 125 rue de Stalingrad, 93000, Bobigny, France

    Philippe Wind & Alban Zarzavadjian Le Bian

Authors
  1. Carlotta Ferretti
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  2. David Fuks
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  3. Philippe Wind
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  4. Alban Zarzavadjian Le Bian
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Corresponding author

Correspondence to Alban Zarzavadjian Le Bian.

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Conflict of interest

CF, DF, PW, and AZLB have no conflict of interest considering this manuscript.

Ethical approval

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.

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Informed consent to publication of the video and images in this article was obtained from the concerned patient.

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Ferretti, C., Fuks, D., Wind, P. et al. Laparoscopic management of sigmoid colon gallstone ileus. Tech Coloproctol 22, 605–606 (2018). https://doi.org/10.1007/s10151-018-1818-x

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  • DOI: https://doi.org/10.1007/s10151-018-1818-x

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