Deepika Koganti, Stephen Doane, Francesco Palazzo, Michael Pucci. Thomas Jefferson University
Gallstone ileus is a rare cause of bowel obstruction but is associated with a high mortality. Surgical management involves enterotomy with removal of the obstructing gallstone. A cholecystectomy and takedown of cholecystoenteric fistula may or may not be performed at that time. We present a novel management option for gallstone ileus: laparoscopic enterotomy with cholecystotomy and stone extraction. With this approach, the patient receives the benefits of minimally invasive surgery. Moreover, the risks of bile duct injury and a high output enteric fistula are minimized by avoiding cholecystectomy. Finally, by extracting remaining gallstones through the cholecystotomy, the risk of recurrent gallstone ileus is decreased.