Endoscopic laser lithotripsy for gallstone large bowel obstruction

Alkhusheh, M; Af, Tonsi; Reiss, Steven J.; Rtc, Owen E; K, Reddy

doi:10.5348/ijcri-2011-04-28-cr-3

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…However, five patients (13.1%) died post-procedure during their admission. Four [ 10 , 29 , 33 , 36 ] died following surgical management and one patient after endoscopic lithotripsy [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

A systematic review of gallstone sigmoid ileus management

Farkas

Kaur

Shanmuganandan

et al. 2018

Annals of Medicine and Surgery

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IntroductionGallstone sigmoid ileus is a rare although serious complication of cholelithiasis resulting in large bowel obstruction. The condition accounts for 4% of all gallstone ileus patients. There are no recognized management guidelines currently. Management strategies range from minimally invasive endoscopy and lithotripsy to substantial surgery. We aim to identify trends when managing patients with gallstone sigmoid ileus to help improve outcomes.MethodsLiterature searches of EMBASE, Medline and by hand were conducted. All English language papers published from 2000 to 2017(Oct) were included. The terms 'gallstone', 'sigmoid', 'colon', 'ileus', 'coleus' and 'large bowel obstruction' were used.Results38 papers included, male:female ratio was 8:30. Average age was 81.11 (SD ± 7.59). Average length of preceding symptoms was 5.31days (+/-SD3.16). 20/38 (59%) had diverticulosis. 89% of patients had significant comorbidities documented. 34/38 patients underwent computerized tomography. 31 stones were located within sigmoid colon, 4 at rectosigmoid junction and 2 within descending colon. Average impacted gallstone size was 4.14 cm (2.3–7 cm range). 23/38 (61%) patients' initial management was conservative or with endoscopy ± lithotripsy. Conservative management successfully treated 26% of patients. 28/38 (74%) patients ultimately underwent surgical intervention. 5/38 patients died post-operatively. Patients treated non-operatively had shorter hospital stays (4:12.3days) although not significant (p-value = 0.0056).ConclusionsThere is no management consensus from the literature. Current evidence highlights endoscopy and lithotripsy as practical firstline strategies. However, surgical intervention should not be delayed if non-operative measures fail or in emergency. Given the complexity of such patients, less invasive timesaving surgery appears practical, avoiding bowel resection and associated complications.

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Section: Resultsmentioning

confidence: 99%

A systematic review of gallstone sigmoid ileus management

Farkas

Kaur

Shanmuganandan

et al. 2018

Annals of Medicine and Surgery

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“…Non-surgical management strategies such as lithotripsy and endoscopic snare/basket retrieval have yielded varying results. Several authors describe successful resolution of large bowel obstruction with lithotripsy [8] , [9] , [10] , [11] , [12] , [13] .…”

Section: Discussionmentioning

confidence: 99%

A single centre case series of gallstone sigmoid ileus management

Farkas

Karthigan

Lewis

et al. 2017

International Journal of Surgery Case Reports

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HighlightsGallstone sigmoid ileus is a rare condition caused by a stone obstructing the sigmoid colon.Manual evacuation of an obstructing gallstone has not previously been documented before.No center has reported more than one case; consequently no case series are documented in the literature.Where conservative measures fail, endoscopy/lithotripsy appear valuable next line interventions.Gallstone ileus can progress to gallstone sigmoid ileus.

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“…Nonoperative management of GI includes various lithotripsy techniques including electrohydraulic, endoscopic mechanical, extracorporeal shock wave, and intracorporal laser lithotripsy. [13141516] These techniques are commonly used for gallstones impacted proximal to upper jejunum or in the colon because of simpler access to these locations. However, the most common site of gallstone impaction is terminal ileum (up to 73%).…”

Section: Discussionmentioning

confidence: 99%

An intriguing case of gallstone ileus after hepaticojejunostomy caused by a "stone on a suture"

Gachabayov

Mityushin

2016

J Res Med Sci

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Gallstone ileus (GI) is a mechanical obstruction of small or large bowel caused by gallstone passed to the intestinal lumen through spontaneous or postoperative biliodigestive fistula. A 42-year-old female patient was admitted with the clinical presentation of small bowel obstruction. She underwent hepaticojejunostomy 4 years prior to admission for primary sclerosing cholangitis. Barium meal follows through revealed Rigler's triad. The patient underwent laparotomy which revealed GI. A “stone on a suture” was removed through enterotomy. Patients after cholecystectomy and hepaticojejunostomy can develop GI. Nonabsorbable suture used to create biliodigestive anastomosis can appear to become the frame of a “stone on a suture.”

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Endoscopic laser lithotripsy for gallstone large bowel obstruction

Cited by 7 publications

References 6 publications

A systematic review of gallstone sigmoid ileus management

A systematic review of gallstone sigmoid ileus management

A single centre case series of gallstone sigmoid ileus management

An intriguing case of gallstone ileus after hepaticojejunostomy caused by a "stone on a suture"

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