Evaluation of Laparoscopic Cholecystotomy in the Treatment of Gallbladder Stones

Frimberger, E; Zillinger, C.; Classen, Meinhard

doi:10.1055/s-2007-1010567

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This implied that the technique reported here is effective and a fair way to manage gallbladder polyps. Percutaneous endoscopic access to the gallbladder has been successfully applied in the treatment of gallbladder diseases [3,17,22]. Only one polyp was resected by conventional electrocautery snare [22].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A New Innovative Technique to Preserve Gallbladder Function in Patients with the Polypoid Lesions of the Gallbladder

Ji¹,

Peng²

2004

Visc Med

View full text Add to dashboard Cite

Background: Gallbladder polyps are frequently discovered in recent years. If polyps are benign and the gallbladder has a good function, there is no absolute indication for cholecystectomy. Thus, a procedure for percutaneous cholecystoscopic polypectomy of the gallbladder polyps was developed and applied. Patients and Methods: 85 patients with gallbladder polyps who underwent percutaneous endoscopic polypectomy were studied. Under epidural anesthesia, a minilaparotomy (2.5–3.0 cm) was performed subcostly in the right upper quadrant, and the gallbladder fundus was then pulled out of the abdominal cavity with a grasping forceps. A rigid or flexible cholecystoscope was introduced into the gallbladder. The polyp stalk or the basement mucosa of the polyps was coagulated using a self-made microwave coagulator, then the polyps were removed for histopathological evaluation. The preserved gallbladder was followed up to evaluate the efficacy of this gallbladder-preserving technique. Results: All procedures were uneventful, with a mean operation time of 1 h. 67 patients were followed up for a mean of 5.5 years (range 2–9 years). 64 patients were symptom-free, and their gallbladder function was found to be well preserved, without recurrence of polyps and occurrence of gallstones on ultrasonography. The other 3 patients had mild upper abdominal discomfort, and their gallbladder function proved to be insufficient with additional gallstone formation. Their gallbladders were removed laparoscopically. Conclusion: The minimal invasive procedure reported here is reliable, simple, and applicable to remove gallbladder polyps and to preserve gallbladder function in patients with benign gallbladder polyps.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Percutaneous endoscopic access to the gallbladder has been successfully applied in the treatment of gallbladder diseases [3,17,22]. Only one polyp was resected by conventional electrocautery snare [22]. The disadvantage of this method is that complete coagulation of the polyps may occur and prevent histological assessment.…”

Section: Discussionmentioning

confidence: 99%

A New Innovative Technique to Preserve Gallbladder Function in Patients with the Polypoid Lesions of the Gallbladder

Ji¹,

Peng²

2004

Visc Med

View full text Add to dashboard Cite

show abstract

Rapid formation of cholesterol crystals in gallbladder bile is associated with stone recurrence after laparoscopic cholecystotomy

et al. 1997

View full text Add to dashboard Cite

it avoids injury to the common biliary duct and leaves the Laparoscopic cholecystotomy (LCT) with subsequent gallbladder in situ after the removal of stones. extraction of gallstones and primary closure of the gall-The technique can be used in patients with a functioning bladder has been introduced as an alternative therapy gallbladder irrespective of the composition or number of for patients with cholecystolithiasis and preserved gallstones. However, stone recurrence has to be considered a bladder function. However, stone recurrence has to be major drawback. Postdissolution trials have shown that considered as a major drawback that might be related when gallbladder stones have been completely dissolved and to lithogenic factors of gallbladder bile or the composibile-acid treatment is withdrawn, stones recur in 28% to 61% tion of gallbladder stones. Therefore, these were studied of patients after 2 to 12 years. [3][4][5] Comparable results were in relation to stone recurrence within an observation obtained after successful treatment of gallbladder stones by period of 1 to 5 years (median, 3.6 years) in 50 patients extracorporeal shock wave lithotripsy (ESWL). 6-8 Therefore, after LCT. The concentrations of total and individual the study of factors associated with recurrent stones is of bile acids, phospholipids, cholesterol, total lipids, mucin, crucial importance. The impact of impaired motility of the protein, and the cholesterol saturation indices in gallgallbladder on gallstone recurrence after ESWL has been bladder bile were not significantly different between 10 demonstrated recently. 9 However, nothing is known whether patients with and 40 patients without stone recurrence.lithogenic factors of gallbladder bile or the composition of However, the crystal observation time was significantly stones might affect recurrence rates after successful gallstone (P õ .02) shorter (range, 1-2 days; median, 1.5) in the treatment that leaves the gallbladder in situ. The introducbile of patients with stone recurrence compared to those tion of LCT as an alternative treatment of gallstones allows without (range, 1-21 days, median 3.5). Moreover, all 10 for the first time a prospective study of these relationships. stone recurrences were observed in the 28 patients withThis prompted us to analyze gallbladder bile and stones cola crystal observation time in the bile of less than or equal lected at the time of LCT and to compare these data with the to 2 days (approximate annual risk: 12%-15%), and no rate of stone recurrence as determined by repeated ultrasorecurrences were observed in the 22 patients with a crysnography. tal observation time greater than 2 days (P õ .0001) or in patients with pigment stones. The rapid formation of PATIENTS AND METHODS cholesterol monohydrate crystals in bile seems to be the major risk factor for recurrent stones after LCT. These Patients and Collection of Bile. Fifty patients, 38 women (mean are most likely cholesterol stones and, therefore, are age range, 47.8 { 10.5 years) and 12 men (mean...

show abstract

Evaluation of Laparoscopic Cholecystotomy in the Treatment of Gallbladder Stones

Cited by 2 publications

References 0 publications

A New Innovative Technique to Preserve Gallbladder Function in Patients with the Polypoid Lesions of the Gallbladder

A New Innovative Technique to Preserve Gallbladder Function in Patients with the Polypoid Lesions of the Gallbladder

Rapid formation of cholesterol crystals in gallbladder bile is associated with stone recurrence after laparoscopic cholecystotomy

Contact Info

Product

Resources

About