Objective: We hereby analyzed a series of gallstone ileus cases operated on in our department starting from a Bouveret syndrome case.Method: Retrospective analysis of all gallstone ileus cases who underwent surgery in our department during the last 26 years. We took into consideration diagnostic elements, time from admission to surgery, type of surgery and post-operative outcome.Results: During this period 9,143 gallstones were deferred to surgery; 27 biliary-digestive fistulae were discovered during surgery; gallstone ileus complicated fistula in 8 patients. Gallstone ileus was exclusively present in elderly women with associated comorbidities. Diagnosis was suggested by clinical features of acute or incomplete intestinal obstruction; it was sustained by imagistic studies with different degrees of relevance. The average time from admission to surgery was 2.6 days. Surgical approach varied from simple enterolithotomy to additional fistula repair. The outcome was uneventful in most of the cases with only one exception.Conclusions: gallstone ileus is a rare condition, occurring in elders with important comorbidities. The choice for surgical procedure depends on the obstructive syndrome's gravity and associated comorbidities; the type of intervention does not significantly influence post-operative morbidity and mortality rates.

Scop: propunem o analizã a cazurilor de ileus biliar operate în clinicã, prilejuitã de un caz de sindrom Bouveret. Metoda: studiu retrospectiv al cazurilor de ileus biliar operate în clinica noastrã în ultimii 26 de ani, urmãrind elementele diagnostice, intervalul scurs pânã la operaåie, tipul intervenåiei şi evoluåia post-operatorie. Rezultate: în aceastã perioadã s-au operat 9143 litiaze biliare descoperindu-se 27 fistule biliodigestive din care 8 s-au complicat cu ileus biliar. Ileusul a survenit exclusiv la femei vârstnice cu comorbiditate importantã. Diagnosticul sugerat de semnele clinice ale ocluziei acute sau subacute, a fost susåinut de investigaåii imagistice a cãror valoare diagnosticã a fost diferitã. Intervalul scurs de la internare pânã la operaåie a fost de 2,6 zile. Atitudinea chirurgicalã a oscilat între simpla enterolitotomie şi asocierea acesteia cu desfinåarea fistulei biliodigestive. Evoluåia a fost favorabilã în majoritatea cazurilor cu o excepåie (1 deces). Concluzii: ileusul biliar este o afecåiune rarã, survenitã la vârstnici cu comorbiditate importantã. Alegerea procedeului chirurgical depinde de impactul sidromului ocluziv şi de comorbiditatea asociatã, tipul intervenåiei neinfluenåând semnificativ morbiditatea şi mortalitatea post-operatorie.