Changes in reservoir and motor-evacuatory function of the gallbladder in patients with asymptomatic cholecystolithiasis after organ-sparing surgery – laparoscopic cholecystolithotomy

Authors

DOI:

https://doi.org/10.14739/2310-1237.2022.1.254270

Keywords:

asymptomatic diseases, cholecystolithiasis, gallbladder reservoir function, gallbladder motor-evacuatory function, cholecystolithotomy, laparoscopy, ultrasonography

Abstract

Sonographic assessment of gallbladder structure and function in patients with gallstone disease needs further improvement not only to clarify the indications for organ-sparing operations such as laparoscopic cholecystolithotomy, but also to improve the results of surgical treatment of asymptomatic cholecystolithiasis by predicting probable restoration of motor-evacuatory function of the gallbladder and reduction of the number of recurrences of cholecystolithiasis.

The aim of the study was to investigate changes in gallbladder structure and function in patients with asymptomatic cholecystolithiasis before and after laparoscopic cholecystolithotomy.

Materials and methods. The study involved 33 patients with asymptomatic cholecystolithiasis. The majority of patients are women 82 % (n = 27), aged 23 to 54 years, mean age 48.0 ± 11.9 years. And there were 18 % of men (n = 6), aged 25 to 58 years, mean age 46.2 ± 12.4 years. Ultrasound examination of the abdominal organs was performed in all patients using Philips No. MA2540R and LOGIQ General Electric Ser No. 52993WX3 before and after laparoscopic cholecystolithotomy. During the examination, a sonographic assessment of the shape, size, contours, thickness of the gallbladder wall, as well as its relation with surrounding organs and vascular structures was performed. The size of the common bile duct, the number and size of stones in the gallbladder cavity, as well as its motor-evacuatory function were purposefully determined. Statistical processing of the material was performed using the Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J).

Results. Indicators of gallbladder reservoir function before and after laparoscopic cholecystolithotomy did not differ significantly. There was a significant increase in the ejection fraction of the gallbladder from 54.5 ± 2.1 % to 64.4 ± 2.9 % (P = 0.0001) and a reduction in the “latency period” from 15.6 ± 2.5 min to 8.3 ± 1.7 min (P = 0.001).

Conclusion. Adherence to sonographic indications (single gallstones, less than 3 mm wall thickness and ejection fraction over 50 %) in the selection of patients with asymptomatic cholecystolithiasis for laparoscopic cholecystolithotomy allows not only to preserve the reservoir and also improve the motor-evacuatory function of it, which reduces the risk of possible recurrent stone formation in close and long-term periods of observation.

Author Biography

D. V. Syvolap, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Assistant of the Department of Faculty Surgery

References

Hong, S. N., Lee, J. K., Lee, K. T., Heo, J. S., Choi, S. H., Rhee, P. L., Paik, S. W., Yoo, B. C., & Rhee, J. C. (2004). Usefulness of gallbladder ejection fraction estimation to predict the recurrence of biliary pain in patients with symptomatic gallstones who did not undergo cholecystectomy. Digestive diseases and sciences, 49(5), 820-827. https://doi.org/10.1023/b:ddas.0000030094.84619.22

Irshad, A., Ackerman, S. J., Spicer, K., Baker, N. L., Campbell, A., Anis, M., & Shazly, M. (2011). Ultrasound evaluation of gallbladder dyskinesia: comparison of scintigraphy and dynamic 3D and 4D ultrasound techniques. AJR. American journal of roentgenology, 197(5), 1103-1110. https://doi.org/10.2214/AJR.10.5391

Li, W., Huang, P., Lei, P., Luo, H., Yao, Z., Xiong, Z., Liu, B., & Hu, K. (2019). Risk factors for the recurrence of stones after endoscopic minimally invasive cholecystolithotomy in China: a meta-analysis. Surgical endoscopy, 33(6), 1802-1810. https://doi.org/10.1007/s00464-018-6455-y

Liu, J., Li, J., & Zhao, Q. (2009). The analyses of the results of 612 cases with gallbladder stones who underwent fibrocholedocoscope cholecystectomy for removal of caculas and preservation of gallbladder. Mag Chin Surg, 47, 279-281. [in English].

Portincasa, P., Moschetta, A., Colecchia, A., Festi, D., & Palasciano, G. (2003). Measurements of gallbladder motor function by ultrasonography: towards standardization. Digestive and liver disease, 35 Suppl 3, S56-S61. https://doi.org/10.1016/s1590-8658(03)00096-3

Shabanzadeh, D. M., Sørensen, L. T., & Jørgensen, T. (2016). Determinants for gallstone formation - a new data cohort study and a systematic review with meta-analysis. Scandinavian journal of gastroenterology, 51(10), 1239-1248. https://doi.org/10.1080/00365521.2016.1182583

Shabanzadeh, D. M. (2018). Incidence of gallstone disease and complications. Current opinion in gastroenterology, 34(2), 81-89. https://doi.org/10.1097/MOG.0000000000000418

Ye, L., Liu, J., Tang, Y., Yan, J., Tao, K., Wan, C., & Wang, G. (2015). Endoscopic minimal invasive cholecystolithotomy vs laparoscopic cholecystectomy in treatment of cholecystolithiasis in China: a meta-analysis. International journal of surgery, 13, 227-238. https://doi.org/10.1016/j.ijsu.2014.12.014

Zhang, Y., Peng, J., Li, X., & Liao, M. (2016). Endoscopic-Laparoscopic Cholecystolithotomy in Treatment of Cholecystolithiasis Compared With Traditional Laparoscopic Cholecystectomy. Surgical laparoscopy, endoscopy & percutaneous techniques, 26(5), 377-380. https://doi.org/10.1097/SLE.0000000000000305

Shevchenko, B., Babiy, A., & Shularenko, N. (2014). Otsenka effektivnosti organosokhranyayushchikh operatsii pri neoslozhnennom kholetsistolitiaze [Assessment of efficiency of organ-preserving operations at uncomplicated cholecystostolithiasis]. GISAP: Medical Science, Pharmacology, (3), 18-21. [in Russian].

Published

2022-04-15

How to Cite

1.
Syvolap DV. Changes in reservoir and motor-evacuatory function of the gallbladder in patients with asymptomatic cholecystolithiasis after organ-sparing surgery – laparoscopic cholecystolithotomy. Pathologia [Internet]. 2022Apr.15 [cited 2024Apr.16];19(1):65-9. Available from: http://pat.zsmu.edu.ua/article/view/254270

Issue

Section

Original research