APPROCCIO DIAGNOSTICO E TERAPEUTICO NELL'ILEO BILIARE

Gallstone ileus is a rare complication of cholecystolithiasis with a high morbility and mortality due to advanced age of patients and often delayed diagnosis due to unspecificity of laboratory pictures and radiological exams. Surgical management is not well establish. There are two options: simple enterolithotomy or the one step procedure (enterolithotomy, cholecystectomy and fisola closure).Three cases of gallstone ileus due to a cholecystoduodenal fistula occurred during the last two years, admitted with unspecific diagnosis of acute abdomen, are reported. In all cases the one step procedure was performed with low morbility and without mortality. The usefulness of laparoscopy in all cases of mechanical ileus with laparoscopic ultrasonography in suspicion of a bilio-enteric fistula is described.