Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients
Tao Wang1, Hao Luo1, Hong-Tao Yan1
1General Surgery Center, Chengdu Military General Hospital, Chengdu, Sichuan, People's Republic of China.
Clinical Interventions in Aging
|February 1, 2017
Summary
Percutaneous cholecystostomy combined with a choledochoscope (PCCLC) may preserve gallbladder function in elderly patients with gallstones. However, careful patient selection and limited lithotrity are crucial to avoid complications.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Biliary System Disorders
Background:
- Cholelithiasis is prevalent in elderly patients, with cholecystectomy as the standard treatment.
- A novel minimally invasive approach, percutaneous cholecystostomy combined with a choledochoscope (PCCLC), was developed for cholecystolithotomy under local anesthesia.
Purpose of the Study:
- To evaluate the impact of PCCLC on gallbladder contractility.
- To compare PCCLC with laparoscopy combined with a choledochoscope in terms of gallbladder function.
Main Methods:
- Comparative study involving PCCLC and laparoscopic cholecystoscopy.
- Assessment of gallbladder contractility using ejection fraction.
- Logistic regression analysis to identify risk factors for postoperational gallbladder ejection fraction.
Main Results:
- PCCLC group showed higher pre- and post-operative age, ASA scores, lithotrity rates, and common bile duct stone rates.
- No significant difference in pre- and post-operative gallbladder ejection fraction between the groups.
- Gallbladder wall thickness and lithotrity were identified as risk factors affecting gallbladder ejection fraction.
Conclusions:
- PCCLC is a cautious strategy, suitable for small gallstones in high-risk elderly patients.
- Limiting lithotrity is essential to maintain gallbladder contractility and reduce the risk of secondary common bile duct stones.
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