Chronic acalculous gallbladder disease: outcomes of treatment by laparoscopic cholecystectomy

The diagnosis and treatment of chronic acalculous gallbladder disease (CAGD) remains controversial. Laparoscopic cholecystectomy (LC) is increasingly accepted as the treatment of choice for this condition. The purpose of this study was to analyse the outcomes from LC for CAGD and to identify potential prognostic factors.

We retrospectively analysed 54 patients with a clinical diagnosis of CAGD. All patients underwent LC. The outcomes were evaluated at 12 months. Outcomes from surgery were graded on a predetermined scoring system (score 1-6) reflecting the effect of surgery on symptomatology. Histopathological analysis was systematically performed on the resection specimens.

Post-operatively, 90.8% of patients (49/54) were satisfied with the operation (outcome score 1-2). A pathological abnormality was detected in 40 patients (74.1%). Of those in whom no abnormality detected on histopathological examination, LC achieved a successful outcome (score 1-2) in 85.7% of patients (12/14). The worst outcomes (score 5-6) were observed in 2 patients with a pathological abnormality of the gallbladder. For the 5 patients with outcome scores of 3 to 6 (poor outcome), the mean duration of symptoms was 7.1 months compared to 18.2 months for patients with score of 1 and 2 (good outcome).

There is no significant correlation between outcomes from LC for CAGD and the existence of a definable underlying pathology (p>0.05). Patients with long-standing symptoms were more likely to benefit from LC (p=0.039). LC is an appropriate treatment option for CAGD.