Cholecystolithoextraction as One of the Methods of Treating Uncomplicated Cholelithiasis

Tegai AV

Published on: 2025-05-19

Abstract

The aim of the scientific work was to determine the possibility of carrying out endoscopic methods for removing stones from the gallbladder while preserving the bladder itself (laparoscopic cholecystolithoextraction) as one of the methods of treating uncomplicated cholelithiasis. Organ-conserving operations for cholelithiasis, due to the preservation of the bile outflow mechanism, do not lead to an increase in the load on the sphincter of Oddi and can be considered as a method of preventing postcholecystectomy syndrome in the postoperative period. Under postcholecystectomy syndrome, we considered all cases of the development of postoperative complications, including dysfunction of the sphincter of Oddi, as well as the development of diseases of the hepatopancreatoduodenal zone. In the Republican Center for Functional Surgical Gastroenterology (Krasnodar, Russian Federation), in 2004-2006, improved methods of laparoscopic cholecystolithoextraction were patented and introduced, and indications for organ-preserving intervention were formulated. In the period from 2004 to 2008, 12 patients with cholelithiasis were operated on. Of these, at the first control examination (on average 2 years and 2 months after surgery), a relapse was detected in 3 patients; the remaining patients felt satisfactory. At the second control examination (in an average period of 15 years and 6 months), of the remaining 9 patients, no stones were detected in 3 patients, laparoscopic cholecystectomy was performed in 3 patients (in 2013, 2021, and 2022) as a result of repeated stone formation, and for 3 patients the connection could not be established. That is, at least 3 out of 12 operated patients had no stones (25%) in the gallbladder 15 years after surgery, despite the lack of follow-up of the patients. There were no signs of the development of postcholecystectomy syndrome in these patients. Undoubtedly, the percentage of favorable results can be improved with proper postoperative management of patients. Based on the results of the study, we can conclude that it is possible to carry out organ-preserving interventions for cholelithiasis with a high risk of developing postcholecystectomy syndrome in patients with cholecystolithiasis. We continue our work to study the course of the disease and predict treatment outcomes in patients after surgical treatment of cholecystolithiasis.