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The role of cholecystectomy in renal transplantation
M Sianesi1, E Capocasale, G Ferreri
1Department of Surgery, Institute of General Surgery and Organ Transplantation, University of Parma, Enzi Capocasale, Via Bizzozero 7, 43100 Parma, Italy. chirtrap@unipr.it
Introduction:
We reviewed our clinical experience to assess the role of cholecystectomy transplant candidates pre- and posttransplantation.
Methods:
Between April 1986 and December 2003, 57 (6.8%) candidates among 839 kidney transplants were found during routine pretransplant screening to show gallstones.
Results:
Thirty nine (68.4%) symptomatic patients underwent cholecystectomy before transplantation. Among 18 (31.6%) asymptomatic patients monitored after transplantation, the 7 (39%) who developed biliary tract symptoms underwent laparoscopy or minilaparocholecystectomy without postoperative morbidity, mortality, or graft loss.
Conclusions:
Symptomatic gallstones have to be treated using the laparoscopic cholecystectomy or minilaparotomy technique. In asymptomatic cholelithiasis prophylactic cholecystectomy is only reserved for patients with biliary "intrinsic" risk factors. An early diagnosis and prompt surgical treatment yields good results.
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