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The authors describe 3 cases of gallstone ileus observed in two different hospitals and evaluate the current rarity of this
complication of the biliary lithiasis and/or of cholangiocarcinomas. There were two cases of stones at the ileal level and
one case in the left colon. In one case a single surgical intervention was carried out while in the other a two-step strategy
was adopted. Notwithstanding the fact that the correct strategy to adopt is still controversial in literature, the authors
discuss the single and double step strategies and propose that the second intervention of the 2-step strategy should not be
performed in high risk surgical patients.