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February 1965

One-Stage Repair for Cholecyst-Duodenal Fistula and Gallstone Ileus

Author Affiliations

From the State University of New York, Downstate Medical Center, Brooklyn, NY and The Long Island Jewish Hospital New Hyde Park, LI, NY.

Arch Surg. 1965;90(2):313-316. doi:10.1001/archsurg.1965.01320080137028

IN 1922 Pybus successfully extracted an obstructing gallstone from the ileum, closed the duodenal fistula, and drained the gallbladder after removing two additional stones from it. This was done because of the author's previous disastrous experience with recurrent gallstone ileus.1 Seven years later Holz removed a faceted stone from the sigmoid and was obliged to close the cholecyst-duodenal fistula while removing a second stone that was impacted in the duodenum. In addition he elected to remove the gallbladder. The patient survived and Holz commented that with similar findings such a procedure can be recommended if the patient's general condition is satisfactory.2 Welch et al (1957) in dealing with a recurrent gallstone intestinal obstruction performed a successful one-stage resection in a patient who was well prepared for three days preoperatively. Again the authors suggested the feasibility of the operation under optimal conditions.17 We are not aware of any