MedPath

Colonic Gallstone Ileus, Diagnostic-therapeutic Algorithm

Conditions
Gall Stone
Interventions
Procedure: operation or non-operative treatment
Registration Number
NCT04961411
Lead Sponsor
Tomislav Bruketa
Brief Summary

Gallstone ileus is a rare complication of gallstone disease. There is no systematic review on CGI. We analyze published literature on the subject and plan to propose a diagnostic-therapeutic algorithm for CGI. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and AMSTAR (Assessing the methodological quality of systematic reviews) guidelines, we will performe a systematic review of English-, German-, Spanish-, Japanese-, and Italian-language articles using PubMed (1946-2021), PubMed Central (1900-2021), and Google Scholar.

The search items include 'gallstone ileus', 'colonic gallstone ileus', 'gallstone coleus', 'cholecystocolonic fistula', 'ileo biliar', 'iléus biliaire', 'ileo di calcoli biliary', 'galsteen ileus', 'fístula colecistocolônica', 'fistule cholécystocolique'. Additional studies will be identified by reviewing reference lists of retrieved studies. We will include all cases and case series with a complete description of CGI.

Exclusion criteria: (1) small bowel gallstone ileus; (2) gastric outlet gallstone ileus; (3) non-gallstone intraluminal obstruction; and (4) cholecystocolonic fistula without CGI.

The primary outcome: a relationship of demographic data, gallstone size, symptoms, obstruction level, risk factors, and comorbidities (biliary history, diverticular disease, cardiovascular disease, radiation of pelvis), diagnostics (palpable mass in the abdomen and rectal exam, laboratory tests, sigmoidoscopy/colonoscopy, x-ray, computed tomography (CT), colonic Rigler's triad) with the correct diagnosis.

The secondary outcome: the identification of therapeutic options and related survival.

The third outcome: to develop a comprehensive diagnostic-therapeutic algorithm for CGI.

The study is exempt from ethics approval because we synthesized data from published studies.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
113
Inclusion Criteria
  • all published cases and case series with a complete description of colonic gallstone ileus
Exclusion Criteria
  • small bowel gallstone ileus; gastric outlet gallstone ileus; non-gallstone intraluminal obstruction; and cholecystocolonic fistula without colonic gallstone ileus

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
published cases of patients with gallstone ileusoperation or non-operative treatmentWe will observe clinical signs, diagnostic procedures and therapeutic procedures and options
Primary Outcome Measures
NameTimeMethod
Gallstone sizeup to 8 weeks

gallstone size

Symptomsup to 8 weeks

possible disease presentation

Obstruction levelup to 8 weeks

level of obstruction in colon

Risk factors and comorbiditiesup to 8 weeks

biliary history, diverticular disease

Diagnostics - clinical examup to 8 weeks

palpable mass in the abdomen

Diagnostics - endoscopyup to 8 weeks

Colonoscopy

Diagnostics - x-rayup to 8 weeks

plain abdominal x-ray

Diagnostics - computed tomographyup to 8 weeks

Abdominal computed tomography

Diagnostics - specific signsup to 8 weeks

Colonic Rigler's triad

Demographic dataup to 8 weeks

male to female ratio

Secondary Outcome Measures
NameTimeMethod
Therapeutic options - operation without resectionup to 8 weeks

number of patients with cololithotomy

Therapeutic options - conservative treatmentup to 8 weeks

number of patients treated conservatively

Survivalup to 8 weeks

Survival of patients according to therapeutic option

Therapeutic options - operation with resectionup to 8 weeks

number of patients with colonic resection

Trial Locations

Locations (1)

University hospital center Zagreb

🇭🇷

Zagreb, Croatia

© Copyright 2025. All Rights Reserved by MedPath