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目的 提高对胆石性肠梗阻的认识，及时明确诊断和手术治疗。方法 回顾性分析１３例胆石性肠梗阻的临床及影像学资料。结果 １３例均经手术治愈，仅３例术前确诊为胆石性肠梗阻。结论 滚动性梗阻是胆石性肠梗阻的特征，及时的Ｂ超和Ｘ线检查有助于早期明确诊断，手术解除结石梗阻是唯一的治疗手段。     

胆石性肠梗阻的诊治(附11例临床分析)

目的探讨胆石性肠梗阻的临床特点和治疗方法. 方法我院1985年～2000年共收治胆石性肠梗阻11例,术前仅3例确诊.均经手术治疗,其中10例行肠管切开取石,1例因肠坏死切除坏死肠段.失访2例,余9例患者一期术后6～9月行胆囊切除和(或)内瘘修补术. 结果Ⅰ期手术后并发呼吸道感染2例,切口感染1例,随访结果显示Ⅱ期手术后9例患者均获治愈. 结论胆石性肠梗阻术前确诊率低,但及时的B超及X线检查有助于其早期诊断,分期手术治疗胆石性肠梗阻效果显著.     

胆石性肠梗阻16例分析

目的:探讨胆石性肠梗阻的临床特点和诊治方法.方法:术前经腹部超声、X线平片和螺旋CT检查,确诊9例.1例经中西医结合非手术治疗排出结石,15例行手术治疗.结果:术后并发切口感染3例,肺感染2例,急性心功能不全1例,均治愈.结论:胆石性肠梗阻术前确诊困难,腹部超声及螺旋CT有助于早期明确诊断.肠管切开取石术在多数患者是首选的治疗方法.     

胆石性肠梗阻4例报告

回顾性分析了4例胆石性肠梗阻病人发病的过程及其诊治情况。4例均于术中确诊，并于梗阻近段切开小肠取出结石，横向关闭小肠切口，术后无并发症，痊愈出院。笔者认为胆石性肠梗阻不易早期诊断；其自身有发病的固有规律，即具有胆囊炎胆石症特点，转变成机械性肠梗阻的临床表现。胆石性肠梗阻有其特征性表现：突发性腹痛、呕吐与症状减轻或完全消失的交替性变化的表现。掌握这些规律和特点再结合影像学检查，有助于早期诊断和治疗。     

胆石性肠梗阻的诊断与治疗

回顾性分析12例胆石性肠梗阻的临床资料。术前确诊率为83.3%,有8例（66.7%）表现为突发性腹痛、呕吐,自行缓解或治疗后症状减轻及消失的交替性变化的特征,即“滚动性肠梗阻”。12例均经手术治疗,其中二期手术8例（66.7%）,1例采用一期手术解决肠道梗阻同时处理病变胆囊和内瘘。3例胆肠内引流术后患者均一期行肠管切开取石,胆肠吻合口切开取石整形术。手术并发症发生率为41.7%,均治愈,无死亡病例。提示：滚动性梗阻是胆石性肠梗阻的特征表现,及时的B超和X线检查有助于早期明确诊断,手术治疗是治疗胆石性肠梗阻最有效的方法。     

胆石性肠梗阻 25例诊治分析

胆石性肠梗阻为胆系结石少见并发症。其是一种特殊类型的机械性肠梗阻，早期诊断不易，常在手术中确诊，病死率较高。我院1990—2005年收治25例，现将诊治体会总结如下。     

胆石性肠梗阻8例报告

我院自1985～1994年，共收治肠梗阻481例，其中胆石性肠梗阻8例(17％)。在肠梗阻中．术前要确诊胆石性肠梗阻较为困难．死亡率为也较高，故本病一旦确诊，应及早手术。现将8例胆石性肠梗阻讨论如下。     

胆石性肠梗阻的诊断与治疗—附15例报道

目的 探讨胆石性肠梗阻的发病机制、诊断及治疗方法。方法 分析讨论15例胆石性肠梗阻病例，并回顾部分国内外资料。结果 15例胆石性肠梗阻病例中，9例误诊。均手术治疗，其中小肠切开取石11例，小肠切开取石、胆囊切除、胆囊十二指肠内瘘修补3例，小肠切除1例。全组均治愈，无死亡。结论 胆石性肠梗阻的发生有增多的趋势，并且绝大部分结石是经胆囊十二指肠内瘘进入肠道的。提高对本病的警惕性，详细了解病史，熟悉其X线、BUS及CT的特征性变化，误诊是可以避免的。本病应根据病情及病变局部情况，分别采取肠道切开取石术、胆囊切除及内瘘修补术进行治疗。     

胆石性肠梗阻的诊断与治疗

目的：探讨胆石性肠梗阻的诊断与治疗,提高对胆石性肠梗阻的认识。方法 ：回顾性分析2014年1月至2019年12月江苏省苏北人民医院收治12例胆石性肠梗阻病人的临床资料,包括临床表现、影像学特征和治疗。结果：12例均出现腹痛、腹胀、恶心、呕吐。术前确诊胆石性肠梗阻6例,其中5例为CT检查确诊,1例为MRI检查确诊。11例行手术治疗,1例保守治疗。其中6例一期行肠切开取石+胆囊切除+胆肠瘘修补术,平均手术时间（167.5±23.2） min,术后平均住院时间（15.5±3.2） d。5例单纯行肠切开取石术,平均手术时间（96.2±31.1） min,术后平均住院时间（16.25±2.7） d。单纯行肠切开取石组病人的手术时间短于一期联合胆囊切除+胆肠瘘修补术组（P<0.05）,但两组术后住院时间比较,差异无统计学意义（P>0.05）。1例保守治疗排石,1年后行胆囊切除、胆肠瘘修补。结论：胆石性肠梗阻临床症状不典型,易漏诊。腹部CT检查有助于诊断,手术为主要治疗方法。     

胆石性肠梗阻的外科诊治体会

目的 总结胆石性肠梗阻的诊断及治疗方法.方法 回顾性分析复旦大学附属上海市第五人民医院2000-2009年收治的12例胆石性肠梗阻患者临床资料.结果 10例患者有明确胆道疾病史,术前经B超、CT确诊11例,12例患者均行手术治疗.切口感染3例,肺部感染1例,无死亡病例,8例获随访无复发.结论 胆石性肠梗阻诊断主要靠病史及影像学检查.手术是目前最有效的治疗方法,应根据具体病情决定手术方式.     

Gallstone ileus: report of a case successfully treated by a laparoscopically-assisted enterolithotomy

Gallstone ileus is an unusual cause of small bowel obstruction that occurs more frequently in elderly patients. The diagnosis is always very challenging and in most of cases this rare complication is misdiagnosed before surgery. The Authors report on a 81-year-old woman with small bowel obstruction who was laparoscopically diagnosed with gallstone ileus and successfully treated by a laparoscopically-assisted enterolithotomy.     

胆囊内瘘的诊治探讨

目的 探讨胆囊内瘘形成的临床特征及诊治手段。方法 回顾总结我院近5年收治的10例胆囊内瘘的诊治经验，分析其临床表现和处理得失。结果 10例均经手术明确诊断，9例痊愈出院，1例因复发胆石性肠梗阻而再次手术，术后死于多器官功能衰竭。结论 胆囊内瘘是胆囊炎胆囊结石产生的危害较严重的并发症。熟悉其发病规律，选择合适的手术时机和正确的处理方法，有利于提高胆囊内瘘的治疗水平。     

El íleo biliar como causa de abdomen agudo. Importancia del diagnóstico precoz para el tratamiento quirúrgico

Gallstone ileus is an uncommon type of mechanical intestinal obstruction caused by an intraluminal gallstone, and preoperative diagnosis is difficult in the Emergency department. This study is a retrospective analysis of the clinical presentation of 5 patients with gallstone ileus treated between 2000-2010. Clinical features, diagnostic testing, and surgical treatment were analyzed. Five patients were included: 2 cases showed bowel obstruction; 2 patients presented a recurrent gallstone ileus with prior surgical intervention; and one patient presented acute peritonitis due to perforation of an ileal diverticula. In all cases CT confirmed the preoperative diagnosis. In our experience, gallstone ileus may present with clinical features other than intestinal obstruction. In suspicious cases CT may be useful to decrease diagnostic delay, which is associated with more complications.     

Gallstone ileus associated with Crohn's disease

Gallstone ileus in association with Crohn's disease of the terminal ileum is a surprisingly uncommon occurrence. The diseased ileal segment may be responsible for gallstone lithogenesis as well as for luminal stenosis that prevents gallstone passage. We report only the third case of gallstone ileus in Crohn's disease and the first to be correctly diagnosed before surgery. The patient was successfully managed by planned ileal resection and cholecystectomy.     

Aspects of diagnosis and therapy of gallstone ileus

The clinical experience with 14 gallstone ileus patients operated within a time period of 17 years is analysed with a survey of the relevant literature. For surgical solution enterolithotomy is recommended. The difficulties of early diagnosis are pointed out with an emphasis, in case of gallstone, on cholecystectomy for prevention of gallstone ileus.     

胆囊十二指肠瘘伴胆石性肠梗阻1例分析并文献复习

目的:探讨胆囊十二指肠瘘合并胆石性肠梗阻的术前评估、诊断和手术方式。方法:回顾性分析1例胆囊十二指肠瘘合并胆石性肠梗阻术前及术中的临床资料,并复习相关文献。结果:患者术前CT检查考虑胆囊结石与胆石性肠梗阻。术中探查见回盲部40cm处结石嵌顿,随后成功行肠切开取石、十二指肠瘘口修补、胆囊切除。术后痊愈出院,随访至目前未见相关并发症。结论:胆囊十二指肠瘘合并胆石性肠梗阻临床罕见,早期的明确诊断及精确的评估是关键,应根据患者具体情况选择合适的手术方式。     

Subtotal colectomy in the course of gallstone-ileus surgery

A big gallstone penetrating through a bilio-digestive fistula into the bowel can make a complete obstruction of it in the majority of the cases requiring an urgent operation. It is a rare situation that a fistula like this leads into the colon and the stone makes a large bowel obstruction. A 72-year-old male patient was admitted to our department with the symptoms of colon obstruction. After the examinations he underwent an explorative laparotomy. During the course of the operation an obstruction was found in the proximal third of the descending colon. A subtotal colectomy was carried out. At the opening of the resected colon a big gallstone was found as the cause of the obstruction, which simulated a tumorous obstruction. We present through this case the possibilities and results of the diagnosis and treatment of gallstone ileus. We conclude that in the prevention of gallstone ileus, the early operative treatment of detected gallstone is essential.     

Laparoscopic Management of a Proximal Jejunal Gallstone <Emphasis Type="Italic">Ileus</Emphasis> with Patulous Ampulla and Choledochal Cyst—a Report of Unusual Presentation and a Review

Gallstone ileus is a diagnosis of rarity, and a proximal site of obstruction in a young patient is even rare. Of the three cases in our experience, we found two cases of gallstone ileus (GSI) with typical epidemiology and presentation, one had combination of multiple rare associations. We report such a case, suspected to have gallstone ileus on ultrasound and confirmed diagnosis on computed tomography. Presence of biliary-enteric fistula, old age, and obstructive features, as in typical cases, was a bigger asset for diagnosis, but it was difficult to entertain diagnosis of GSI in young girl in absence of a demonstrable biliary-enteric fistula, with uncommon association of choledochal cyst and sickle cell disease. A very surprising finding, dilated major papilla, could however explain the pathogenesis which has also been reported in the past. Although differential opinions regarding management exist, we decided to follow two-stage surgery as our institute protocol. A minimal access approach has been immensely helpful in accurate diagnosis, and expedative management with early recovery has been proven in the past studies which we agreed with our experience.