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  • Title: Laparoscopic management of sigmoid colon gallstone ileus.
    Author: Ferretti C, Fuks D, Wind P, Zarzavadjian Le Bian A.
    Journal: Tech Coloproctol; 2018 Aug; 22(8):605-606. PubMed ID: 29980886.
    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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