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


METHODS
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.
Department of General Surgery, Institute for Minimally Invasive Surgery, Zhongda Hospital, Medical School, Southeast University, Nanjing, PR China.
Yu-Yan
YY
Tan
Gang
G
Zhao
Dong
D
Wang
Jing-Min
JM
Wang
Jie-Rong
JR
Tang
Zhen-Ling
ZL
Ji
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041761:Cholecystolithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D014463:Ultrasonography; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage; D055815:Young Adult
D014580:Ursodeoxycholic Acid