Bouveret's syndrome: presentation of two cases with review of the literature and development of a surgical treatment strategy

Nickel, Felix; Müller-Eschner, Matthias M.; Chu, Jackson; von Tengg-Kobligk, Hendrik; Müller-Stich, Beat P. (2013). Bouveret's syndrome: presentation of two cases with review of the literature and development of a surgical treatment strategy. BMC surgery, 13, p. 33. BioMed Central 10.1186/1471-2482-13-33

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BACKGROUND Bouveret's syndrome causes gastric outlet obstruction when a gallstone is impacted in the duodenum or stomach via a bilioenteric fistula. It is a rare condition that causes significant morbidity and mortality and often occurs in the elderly with significant comorbidities. Individual diagnostic and treatment strategies are required for optimal management and outcome. The purpose of this paper is to develop a surgical strategy for optimized individual treatment of Bouveret's syndrome based on the available literature and motivated by our own experience. CASE PRESENTATION Two cases of Bouveret's syndrome are presented with individual management and restrictive surgical approaches tailored to the condition of the patients and intraoperative findings. CONCLUSIONS Improved diagnostics and restrictive individual surgical approaches have shown to lower the mortality rates of Bouveret's syndrome. For optimized outcome of the individual patient: The medical and perioperative management and time of surgery are tailored to the condition of the patient. CT-scan is most often required to secure the diagnosis. The surgical approach includes enterolithotomy alone or in combination with simultaneous or subsequent cholecystectomy and fistula repair. Lower overall morbidity and mortality are in favor of restrictive surgical approaches. The surgical strategy is adapted to the intraoperative findings and to the risk for secondary complications vs. the age and comorbidities of the patient.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

von Tengg-Kobligk, Hendrik

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1471-2482

Publisher:

BioMed Central

Language:

English

Submitter:

Aisha Stefania Mzinga

Date Deposited:

13 May 2014 08:44

Last Modified:

22 Dec 2014 19:07

Publisher DOI:

10.1186/1471-2482-13-33

PubMed ID:

24006869

BORIS DOI:

10.7892/boris.52289

URI:

https://boris.unibe.ch/id/eprint/52289

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