A new strategy of minimally invasive surgery for cholecystolithiasis: calculi removal and gallbladder preservation

Dig Surg. 2013;30(4-6):466-71. doi: 10.1159/000357823. Epub 2014 Jan 30.

Abstract

Background: Cholecystolithiasis is a common disease. Cholecystectomy is the main treatment method but is associated with various complications in some patients. This study explores a novel, minimally invasive surgery for the removal of calculi and the preservation of the gallbladder using a laparoscope combined with the soft choledochoscope.

Method: A retrospective analysis was conducted between January 2010 and December 2012 in 65 patients with cholecystolithiasis who underwent the minimally invasive surgery for calculi removal and gallbladder preservation.

Results: In 61 cases of gallstone removal, the gallbladder was preserved perfectly with no complications. The other 4 cases were switched to laparoscopic cholecystectomy because of tiny stones blocking the cystic duct or submucosal stones. The success rate was 93.8%. Follow-up included both clinical assessment and ultrasound examination every 6 months after the operation. The patients with preoperative symptoms were symptom-free, and gallbladder function was well preserved. The overall stone recurrence rate was 4.92% at a mean follow-up of 26 months (range 6-40).

Conclusions: Using the laparoscope combined with the soft choledochoscope for gallbladder-preserving cholecystolithotomy can remove stones, preserve gallbladder function, and effectively avoid the various complications of cholecystectomy. In our follow-up, gallbladder function was not affected and the stone recurrence rate was quite low.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cholecystectomy, Laparoscopic / methods*
  • Cholecystolithiasis / diagnostic imaging
  • Cholecystolithiasis / surgery*
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Organ Sparing Treatments / methods*
  • Recurrence
  • Retrospective Studies
  • Ultrasonography
  • Ursodeoxycholic Acid / administration & dosage
  • Young Adult

Substances

  • Ursodeoxycholic Acid