The effect of laparoscopic cholecystectomy on gastroduodenal reflux

The present study evaluates the effect of laparoscopic cholecystectomy on biliary reflux in patients with cholelithiasis.

All patients over 18 years of age awaiting elective cholecystectomy for gallstone disease in one of two teaching hospitals were contacted by telephone, and those who gave informed consent were entered in the study. A total of 66 patients (43 females and 23 males) underwent milk 99mTc DIDA scans. Elective laparoscopic cholecystectomy was perfomed after a median of 28.5 days (range: 8-588 days) and patients were re-investigated with a milk 99mTc DIDA scan at a median time of 50 days (range: 18-370 days) postoperatively. Scans were carried out in the Nuclear Medicine Department of the Royal Adelaide Hospital.

All but two patients had a functioning gall-bladder on milk 99mTc N-2, 6-dimethylphenyl-carbamoylmethyl iminodiacetic acid scanning prior to cholecystectomy. One of these patients was found to have a gall-bladder carcinoma at cholecystectomy. Fifty-seven of the 66 patients had a successful laparoscopic cholecystectomy (nine open cholecystectomies). Nineteen patients experienced gastroduodenal reflux into the stomach prior to cholecystectomy and 23 patients experienced it postoperatively. There was no significant difference in gastroduodenal reflux in both the open and laparoscopic groups.

The present study demonstrated that laparoscopic cholecystectomy did not significantly alter gastroduodenal reflux.