Ahmet YAVUZ, Emre ŞİMŞEK, Emin YILMAZ, Hikmet Pehlevan ÖZEL, Sadettin ER
Journal of Comprehensive Surgery - 2026;4(2):23-29
Aims: Biliary ileus is a rare clinical condition in which gallstones cause mechanical obstruction in the gastrointestinal tract as a result of biliary enteric fistula formation. The aim of this study is to present the clinical characteristics, diagnostic processes and surgical outcomes of cases undergoing surgical treatment due to biliary ileus. Methods: Twelve patients who underwent surgical treatment for gallstone ileus between February 2019 and June 2025 were retrospectively evaluated. Demographic characteristics, presenting symptoms, laboratory values, type of biliary-enteric fistula, obstruction location, surgical methods used, length of hospital stay and mortality data were analyzed. Results: The mean age of the patients was 77.4+/-10.3 years, and 66% were female. All patients presented with symptoms of intestinal obstruction. Contrast-enhanced computed tomography confirmed intestinal obstruction in all cases and enabled preoperative diagnosis in 11 patients. Cholecystoduodenal fistula was the most common fistula type (91.7%). The obstruction was most frequently located in the ileum (41.7%). Enterotomy/enterolithotomy was the most commonly performed surgical procedure (66.6%). The mean hospital stay was 12.1+/-6.2 days, and one patient (8.3%) died due to postoperative sepsis. Conclusion: Gallstone ileus is a rare cause of intestinal obstruction, frequently seen in the elderly and requiring surgical treatment. The findings of our study demonstrate that early diagnosis with contrast-enhanced CT and a surgical approach to relieve the obstruction constitute an effective treatment strategy.
