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

Ф.А. ХАДЖИБАЕВ, Ф.Б. АЛИДЖАНОВ, А.Б. КУРБОНОВ, Д.Т. ПУЛАТОВ

Abstract

Material and methods. The results of diagnostics and surgical treatment of 58 patients with gallstone ileus
admitted to RRCEM in 2001-2020 are presented. There were 16 men (27.6%) and 42 women (72.4%). The
average 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 with
gallstone ileus included traditional research methods, as well as modern methods of radiation and endovisual
diagnostics.
Results. The frequency of gallstone ileus among patients operated on for acute small bowel obstruction was
3.1%. 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 only
36.2%. The choice of tactics for surgical treatment of patients with gallstone ileus depended on the established
diagnosis and the specific clinical and operational finding.
Conclusion. A large number of complications and mortality accompanies surgery for gallstone ileus. The reason
for this is the elderly and senile age of patients with a large number of concomitant pathologies, late appeal
ability, the difficulty of diagnosis and the invasiveness of the intervention itself. The main way to improve
treatment results in this category is to improve diagnostics and minimize surgical trauma.