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Watanabe Y, Takemoto J, Miyatake E, Kawata J, Ohzono K, Suzuki H, Inoue M, Ishimitsu T, Yoshida J, Shinohara M, Nakahara C. Single-incision laparoscopic surgery for gallstone ileus: An alternative surgical procedure. Int J Surg Case Rep 2014; 5:365-9. [PMID: 24858981 PMCID: PMC4064429 DOI: 10.1016/j.ijscr.2014.04.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 04/16/2014] [Accepted: 04/21/2014] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Gallstone ileus (GI) results from the passage of a stone through a cholecystoenteric fistula, subsequently causing a bowel obstruction. The ideal treatment procedure for GI remains controversial. PRESENTATION OF CASE A 63-year-old female was admitted to our hospital following persistent nausea and vomiting for 7 days. Computed tomography revealed a partially calcified 4-cm circular object in the jejunum, and the proximal intestine was dilated, with concomitant pneumobilia. Based on the preoperative diagnosis of GI, enterotomy with stone extraction by single-incision laparoscopic surgery (SILS) was performed. The patient's postoperative course was uneventful, and the cholecystoduodenal fistula closed spontaneously 4 months after the surgery. DISCUSSION Recent studies have reported that enterotomy with stone extraction alone is associated with better outcomes than with more invasive techniques. This case also suggests that enterotomy with stone extraction alone and careful postoperative follow-up is feasible for the management of GI. Although the use of laparoscopy in the management of GI has been described previously, laparoscopic surgery has not been widely performed, and SILS is not generally performed. When only this less demanding procedure is required, laparoscopic surgery, including SILS, can be a viable option. CONCLUSION SILS can be an alternative surgical procedure for the management of GI.
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Affiliation(s)
- Yusuke Watanabe
- Department of Emergency Medicine, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan.
| | - Junkichi Takemoto
- Department of Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan
| | - Eiji Miyatake
- Department of Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan
| | - Jun Kawata
- Department of Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan
| | - Keigo Ohzono
- Department of Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan
| | - Hiroyuki Suzuki
- Department of Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan
| | - Masaaki Inoue
- Department of Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan
| | - Toshiyuki Ishimitsu
- Department of Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan
| | - Junichi Yoshida
- Department of Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan
| | - Masahiro Shinohara
- Department of Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan
| | - Chihiro Nakahara
- Department of Emergency Medicine, Shimonoseki City Hospital, 1-13-1 Koyo-Cho, Shimonoseki, Yamaguchi, Japan
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