選択された症候性胆石症患者における胆嚢温存胆石摘出術：症例シリーズ

Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic cholelithiasis, but is associated with post cholecystectomy problems in some patients. However, some patients refuse cholecystectomy against organ loss. In suitable patients we employed gallbladder preserving cholelithotomy (GPC) with mini-incision to rid of their stones. Our aim is to introduce our technique of GPC and investigate its safety and efficacy.

Fifty-five biliary colic patients with a strong desire to retain their gallbladders harboring ≤3 gallstones with diameters <3 cm, wall thickness ≤3 mm, and gallbladder ejection fractions >50 % underwent GPC. Assessment of the gallbladder features by ultrasonography every 3 months in the first postoperative year and annually thereafter. We conducted the gastrointestinal quality of life index (GIQLI) survey in the 6th postoperative month.

Fifty-two patients had their gallstones successfully removed. We did not encounter any perioperative complication. We converted to laparoscopic cholecystectomy in three patients, one with multiple polyps and two with inflamed mucosa. Gallbladder ejection fractions in the 3rd postoperative month were statistically better than the preoperative period. The patients with preoperative symptoms were symptom free. The median follow-up time was 3 years. There was no stone recurrence.

GPC is a simple, safe and acceptable procedure. It may be employed in suitable symptomatic patients.