Objective: Unusual clinical course Background: Biliointestinal bypass is a malabsorptive procedure for surgical treatment of morbid obesity. It is the evolution of jejunoileal bypass, and it is characterized by a cholecysto-jejunostomy on the proximal end of the excluded jejunum, therefore, allowing bile flow through the excluded bowel loop reducing the risk of postoperative di-arrhea and malabsorption syndrome. Obesity is a well-known risk factor for cholelithiasis; moreover, bariatric surgery has been showed to increases the risk of gallstones formation. Case Report: A 48-years-old male (body mass index 42 kg/m(2)) received a laparoscopic biliointestinal bypass. Nine years later, the patient received a cholecystotomy for removal of biliary stones. No surgical procedures were performed on the cholecysto-jejunostomy. Fourteen years after the bariatric treatment, the patient underwent enterolithotomy after a diagnosis of gallstone ileus. The impacted biliary stone was documented in the excluded loop proximal to the anti-reflux valvular system. The postoperative course and 1-year follow-up were uneventful. Conclusions: Few cases of gallstone ileus following biliointestinal bypass have been described in the literature. We report a new case and also propose few tips and tricks for cholelithiasis and gallstone ileus prevention after biliointestinal bypass.
Key Points for Cholelithiasis and Gallstone Ileus Prevention Following Biliointestinal Bypass / G. Micheletto, G.N. Piozzi, V. Panizzo, E. Reitano, D. Tringali, A.E. Pontiroli. - In: THE AMERICAN JOURNAL OF CASE REPORTS. - ISSN 1941-5923. - 20(2019 Jul 10), pp. 993-997.
|Titolo:||Key Points for Cholelithiasis and Gallstone Ileus Prevention Following Biliointestinal Bypass|
MICHELETTO, GIANCARLO (Primo) [Conceptualization] (Corresponding)
PIOZZI, GUGLIELMO NICCOLO (Secondo) [Writing – Original Draft Preparation] (Corresponding)
PANIZZO, VALERIO [Methodology]
REITANO, ELISA [Formal Analysis]
PONTIROLI, ANTONIO ETTORE (Ultimo) [Writing – Review & Editing]
|Parole Chiave:||bariatric surgery; gallstones; morbid obesity; postoperative complications|
|Settore Scientifico Disciplinare:||Settore MED/18 - Chirurgia Generale|
|Data di pubblicazione:||10-lug-2019|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.12659/AJCR.916111|
|Appare nelle tipologie:||01 - Articolo su periodico|