Особенности диагностики и тактики лечения больных с билиарным илеусом (20-летний опыт клиники)

Abstract

Material and methods. The results of diagnostics and surgical treatment of 58 patients with gallstone ileusadmitted to RRCEM in 2001-2020 are presented. There were 16 men (27.6%) and 42 women (72.4%). Theaverage age of the patients was 70.4 ± 6.8 years. 53 (91.4%) patients had small bowel obstruction and 5 (8.6%)pyloroduodenal obstruction (the so-called Bouveret syndrome). The diagnostic process in patients withgallstone ileus included traditional research methods, as well as modern methods of radiation and endovisualdiagnostics.Results. The frequency of gallstone ileus among patients operated on for acute small bowel obstruction was3.1%. The complete Riegler triad in plain radiography of the abdominal cavity, specific for gallstone ileus,is extremely rare, and we noted the combination of small intestinal levels of one of its components in only36.2%. The choice of tactics for surgical treatment of patients with gallstone ileus depended on the establisheddiagnosis and the specific clinical and operational finding.Conclusion. A large number of complications and mortality accompanies surgery for gallstone ileus. The reasonfor this is the elderly and senile age of patients with a large number of concomitant pathologies, late appealability, the difficulty of diagnosis and the invasiveness of the intervention itself. The main way to improvetreatment results in this category is to improve diagnostics and minimize surgical trauma.