Biomedical subjects
Publications and source records attributed to J Siebermair.
High lethality of gallstone ileus can be reduced by prompt diagnosis and careful treatment. Aerobilia is of great diagnostic value, in doubtful cases Gastrografin passage of the intestine is useful. Enterolithotomia alone is the least dangerous treatment. However, postoperatively the possibility of a recidive should be kept in mind.
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In a series of 1122 cholecystectomies we observed 15 cases of retained bile duct stones. Early postoperative diagnosis was achieved by T-drain-cholangiography. The application of T-drains was afflicted with a morbidity rate of 3.5%. For treatment we performed 2 relaparotomies, 3 percutaneous extractions, 5 endoscopic extractions, 1 lysis and 1 extracorporal shock-wave-lithotripsy. Using nonsurgical methods there are only few indications for open explorative choledochotomy.
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