{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T08:23:08Z","timestamp":1782462188068,"version":"3.54.5"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[1990,7,1]],"date-time":"1990-07-01T00:00:00Z","timestamp":646790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1990,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Thirty-seven patients (33 women and four men, median age 78 years) were operated on for gallstone ileus over a 12-year period with a median follow-up of 6\u00b72 years. Twenty-three patients (62 per cent) had serious concomitant diseases. Plain abdominal radiographs performed at admission were diagnostic in only 17 patients (46 per cent) and other procedures such as ultrasonography, gastrointestinal contrast studies and computed tomographic scan were required in ten patients (27 per cent). The diagnosis was made before operation in 27 patients (73 per cent) but in only 17 (46 per cent) at admission. Obstructing stones were located in the terminal ileum in 27 patients (73 per cent), in the proximal ileum or jejunum in five (14 per cent), in the duodenum in two (5 per cent), and in the colon in three (8 per cent). In six instances (16 per cent), more than one stone was involved. Cholecystduodenal fistula was the most frequent fistula type (n = 25, 68 per cent), followed by cholecystcolonic (n = 2, 5 per cent) and cholecystduodenocolonic (n = 2, 5 per cent) types. The site of the fistula was not established in the other eight instances. A one-stage procedure consisting of the removal of the impacted stone, fistula repair and cholecystectomy was performed in eight patients, two of whom died. A second group of six patients underwent a two-stage procedure consisting of enterolithotomy followed by elective biliary surgery, with no mortality. Removal of impacted stones was the only surgical treatment in the remaining 23 patients, with five deaths. Operative mortality and morbidity rates associated with the initial procedure did not differ significantly among the three therapeutic groups, which were comparable in terms of patient age, associated concomitant diseases and APACHE II score. However, later biliary complications were prominent in patients treated only by enterolithotomy. These results support the view that a one-stage procedure is, when feasible, a valid option and may be the procedure of choice. When local or surgical conditions argue against a one-stage procedure, biliary surgery at a second stage should be considered, if residual stones are present. In poor risk patients, non-operative methods should be considered.<\/jats:p>","DOI":"10.1002\/bjs.1800770707","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T14:14:24Z","timestamp":1172931264000},"page":"737-742","source":"Crossref","is-referenced-by-count":307,"title":["Gallstone ileus"],"prefix":"10.1093","volume":"77","author":[{"given":"P-A","family":"Clavien","sequence":"first","affiliation":[{"name":"Department of Surgery, Clinic of Digestive Surgery, University Hospital , 1211-Geneva 4,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Richon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Clinic of Digestive Surgery, University Hospital , 1211-Geneva 4,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Burgan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Clinic of Digestive Surgery, University Hospital , 1211-Geneva 4,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Rohner","sequence":"additional","affiliation":[{"name":"Department of Surgery, Clinic of Digestive Surgery, University Hospital , 1211-Geneva 4,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1990,7,1]]},"reference":[{"key":"2024092809034780600_bib1","first-page":"273","article-title":"Gallstone obstruction of the intestine. An analysis of ten patients and a review of the literature","volume":"101","author":"van Hillo","year":"1987","journal-title":"Surgery"},{"key":"2024092809034780600_bib2","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/BF02401638","article-title":"Gallstone ileus: an analysis of 20 patients","volume":"4","author":"Heuman","year":"1980","journal-title":"World J Surg"},{"key":"2024092809034780600_bib3","first-page":"769","article-title":"Spontaneous enterobiliary fistulas","volume":"137","author":"Safaie-Shirazi","year":"1973","journal-title":"Surg Gynecol Obstet"},{"key":"2024092809034780600_bib4","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/00000658-196803000-00011","article-title":"Changing concept in the surgical treatment of gallstone ileus: a review of 15 cases with emphasis on diagnosis and treatment","volume":"167","author":"Cooperman","year":"1968","journal-title":"Ann Surg"},{"key":"2024092809034780600_bib5","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1001\/jama.1962.03050080037008","article-title":"Gallstone ileus","volume":"179","author":"Thomas","year":"1962","journal-title":"JAMA"},{"key":"2024092809034780600_bib6","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/0002-9610(86)90550-7","article-title":"Improving the outcome in gallstone ileus","volume":"151","author":"Deitz","year":"1986","journal-title":"Am J Surg"},{"key":"2024092809034780600_bib7","first-page":"95","article-title":"Patterns of treatment of gallstone ileus over a 45-year period","volume":"80","author":"Kurtz","year":"1985","journal-title":"Am J Gastroenterol"},{"key":"2024092809034780600_bib8","first-page":"435","article-title":"Diagnosis and treatment of gallstone ileus","volume":"148","author":"Svartholm","year":"1982","journal-title":"Acta Chir Scand"},{"key":"2024092809034780600_bib9","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/0002-9610(80)90185-3","article-title":"Gallstone ileus. Review of 112 patients in the Japanese literature","volume":"140","author":"Kasahara","year":"1980","journal-title":"Am J Surg"},{"key":"2024092809034780600_bib10","first-page":"527","article-title":"Biliary enteric fistula","volume":"153","author":"Glenn","year":"1981","journal-title":"Surg Gynecol Obstet"},{"key":"2024092809034780600_bib11","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/0002-9610(75)90315-3","article-title":"Gallstone ileus. Review of the literature and presentation of thirty-four new cases","volume":"129","author":"Day","year":"1975","journal-title":"Am J Surg"},{"key":"2024092809034780600_bib12","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/00000658-197201000-00013","article-title":"Spontaneous internal biliary fistula, obstructive and nonobstructive types","volume":"175","author":"Piedad","year":"1972","journal-title":"Ann Surg"},{"key":"2024092809034780600_bib13","first-page":"61","article-title":"Management of gallstone ileus","volume":"32","author":"Syme","year":"1989","journal-title":"Can J Surg"},{"key":"2024092809034780600_bib14","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/S0039-6109(16)42683-6","article-title":"Gallstone ileus","volume":"62","author":"Van Landingham","year":"1982","journal-title":"Surg Clin North Am"},{"key":"2024092809034780600_bib15","first-page":"540","article-title":"Gallstone obstruction of the intestine","volume":"125","author":"Anderson","year":"1967","journal-title":"Surg Gvnecol Obstet"},{"key":"2024092809034780600_bib16","first-page":"473","article-title":"Gallstone ileus. Is cholecystectomy indicatedarticle-title","volume":"31","author":"Tuell","year":"1965","journal-title":"Am Surg"},{"key":"2024092809034780600_bib17","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/S0039-6109(16)39035-1","article-title":"Planning the operation for cholecystoenteric fistula with gallstone ileus","volume":"50","author":"Fox","year":"1970","journal-title":"Surg Clin North Am"},{"key":"2024092809034780600_bib18","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1097\/00000658-196612000-00015","article-title":"Choice of operation for gallstone intestinal obstruction","volume":"164","author":"Warshaw","year":"1966","journal-title":"Ann Surg"},{"key":"2024092809034780600_bib19","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1001\/archsurg.1965.01320080137028","article-title":"One-stage repair for cholecystoduodenal fistula and gallstone ileus","volume":"90","author":"Berliner","year":"1965","journal-title":"Arch Surg"},{"key":"2024092809034780600_bib20","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1097\/00003246-198510000-00009","article-title":"APACHE II: a severity of disease classification system","volume":"13","author":"Knaus","year":"1985","journal-title":"Crit Care Med"},{"key":"2024092809034780600_bib21","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1001\/jama.1941.02820470001001","article-title":"Gallstone obstruction: pathogenesis and roentgen manifestations","volume":"117","author":"Rigler","year":"1941","journal-title":"JAMA"},{"key":"2024092809034780600_bib22","first-page":"711","article-title":"The radiology corner. Duodenocolonic fistula with gallstone ileus","volume":"68","author":"Hricak","year":"1978","journal-title":"Am J Gastroenterol"},{"key":"2024092809034780600_bib23","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/S0016-5085(19)35068-1","article-title":"Gas in the biliary tract: clinical and experimental observations","volume":"41","author":"Sedlack","year":"1961","journal-title":"Gastroenterology"},{"key":"2024092809034780600_bib24","doi-asserted-by":"crossref","first-page":"219","DOI":"10.2214\/ajr.131.2.219","article-title":"Air in gallbladder: a frequent finding in gallstone ileus","volume":"131","author":"Balthazar","year":"1978","journal-title":"AJR"},{"key":"2024092809034780600_bib25","first-page":"479","article-title":"Value of ultrasonography in the diagnosis of gallstone ileus","volume":"28","author":"Pedersen","year":"1988","journal-title":"Radiologe"},{"key":"2024092809034780600_bib26","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1007\/BF01347916","article-title":"Case report. Endoscopic diagnosis of gallstone ileus of the duodenum","volume":"31","author":"Oakland","year":"1986","journal-title":"Dig Dis Sci"},{"key":"2024092809034780600_bib27","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/BF01297065","article-title":"Gallstone ileus","volume":"32","author":"Cappell","year":"1987","journal-title":"Dig Dis Sci"},{"key":"2024092809034780600_bib28","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/0016-5085(89)90086-3","article-title":"Shock-wave therapy of gastric outlet syndrome caused by a gallstone","volume":"97","author":"Holl","year":"1989","journal-title":"Gastroenterology"},{"key":"2024092809034780600_bib29","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1136\/pgmj.57.663.62","article-title":"Colonic gallstone ileus","volume":"57","author":"Anseline","year":"1981","journal-title":"Postqrad Med J"},{"key":"2024092809034780600_bib30","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/BF02560445","article-title":"Gallstone obstruction of the colon. Report of two cases and review of management","volume":"5","author":"Milsom","year":"1985","journal-title":"Dis Colon Rectum"},{"key":"2024092809034780600_bib31","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1002\/bjs.18004720316","article-title":"Gallstone obstruction ofsigmoid colon with particular reference to aetiology","volume":"47","author":"Pryor","year":"1959","journal-title":"Br J Surg"},{"key":"2024092809034780600_bib32","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1002\/bjs.1800207704","article-title":"A giant gallstone impacted in the colon and causing acute obstruction","volume":"20","author":"Turner","year":"1935","journal-title":"Br J Surg"},{"key":"2024092809034780600_bib33","first-page":"678","article-title":"Zur Pathogenese des Gallensteinileus","volume":"48","author":"Wittmann","year":"1977","journal-title":"Chirurg"},{"key":"2024092809034780600_bib34","first-page":"716","article-title":"Recurrent gallstone ileus","volume":"54","author":"Buetow","year":"1963","journal-title":"Surgery"},{"key":"2024092809034780600_bib35","first-page":"54","article-title":"Operative treatment of gallstone ileus without enterotomy","volume":"95","author":"Kapel","year":"1947","journal-title":"Acta Chir Scand"},{"key":"2024092809034780600_bib36","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/S0016-5107(77)73656-9","article-title":"Colonoscopic diagnosis and relief of large bowel obstruction caused by impacted gallstone","volume":"23","author":"Zaretsky","year":"1977","journal-title":"Gastrointest Endosc"},{"key":"2024092809034780600_bib37","first-page":"166","article-title":"Zur Frage des Gallensteinileus","volume":"155","author":"Holz","year":"1929","journal-title":"Arch Klin Chir"},{"key":"2024092809034780600_bib38","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/S0140-6736(01)01097-2","article-title":"A note on two cases of gallstone ileus","volume":"ii","author":"Pybus","year":"1922","journal-title":"Lancet"},{"key":"2024092809034780600_bib39","doi-asserted-by":"crossref","first-page":"481","DOI":"10.7326\/0003-4819-63-3-481","article-title":"Cholecystocolonic fistula with malabsorption","volume":"63","author":"Elsas","year":"1965","journal-title":"Ann Intern Med"},{"key":"2024092809034780600_bib40","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/0002-9610(62)90227-1","article-title":"Carcinoma of the gallbladder","volume":"103","author":"Bossart","year":"1962","journal-title":"Am J Surg"},{"key":"2024092809034780600_bib41","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/BF02617178","article-title":"Massive lower gastrointestinal haemorrhage from cholecystocolic fistula","volume":"10","author":"Kaplan","year":"1967","journal-title":"Dis Colon Rectum"},{"key":"2024092809034780600_bib42","first-page":"665","article-title":"Gallstone ileus","volume":"137","author":"Raf","year":"1971","journal-title":"Acta Chir Scand"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.1800770707","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/77\/7\/737\/59393068\/bjs1800770707.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/77\/7\/737\/59393068\/bjs1800770707.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T09:04:01Z","timestamp":1727514241000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/77\/7\/737\/6172766"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1990,7,1]]},"references-count":42,"journal-issue":{"issue":"7","published-online":{"date-parts":[[1990,7,1]]},"published-print":{"date-parts":[[1990,7,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.1800770707","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1990,7]]},"published":{"date-parts":[[1990,7,1]]}}}