Zhen-Ling Ji, MD, PhD. Zhongda Hospital, Southeast University School of Medicine
Introduction: Cholecystectomy is the main treatment method but is associated with various complications in some patients. This study explores a novel, endo-lap surgery for the removal of calculi and polyps to preserve the gallbladder using a laparoscope combined with choledochoscope.
Methods: A retrospective analysis was conducted between January 2010 and December 2014 in 65 patients with cholecystolithiasis and 29 with polyps who underwent the endo-lap invasive surgery for calculi /polyp removal and gallbladder preservation.
Results: In 94 cases of gallbladder preservation, the gallbladder was preserved perfectly with no complications. The other 4 cases were switched to laparoscopic cholecystectomy because of tiny stones blocking the cystic duct or submucosal stones. The success rate was 93.8%. Follow-up included both clinical assessment and ultrasound examination every 6 months after the operation. The patients with preoperative symptoms were symptom-free, and gallbladder function was well preserved. The overall stone recurrence rate was 4.94% at a mean follow-up of 36 months (range 6–60).
Conclusions: Using the laparoscope combined with the soft choledochoscope for gallbladder-preserving cholecystolithotomy can remove stones/polyps preserve gallbladder function, and effectively avoid the various complications of cholecystectomy.
In our follow-up, gallbladder function was not affected and the stone recurrence rate was quite low.