Analysis of morphological changes in gallbladder walls after endoscopic bile duct decompression

Abstract

BACKGROUND: In patients who have undergone retrograde endoscopic choledocholithoextraction, technical difficulties are frequently encountered when performing laparoscopic cholecystectomy, which is associated with the development of destructive changes in the gallbladder wall. However, no studies on the assessment of morphological changes occurring in the gallbladder wall at different terms after endoscopic retrograde bile duct interventions are currently available in the literature. The relevance and insufficient knowledge of the research area prompted this study.

AIM: This study aimed to determine the optimal terms of laparoscopic cholecystectomy after endoscopic bile duct decompression performed for cholelithiasis complicated by choledocholithiasis based on morphological changes in the gallbladder wall.

MATERIALS AND METHODS: A comparative analysis of the pathological examination of 198 gallbladders removed surgically on different days after endoscopic bile duct decompression performed for cholelithiasis complicated by choledocholithiasis is presented.

RESULTS: In group 1, cholecystectomy after endoscopic bile duct decompression was performed on days 1–3. Gallbladder wall changes were observed in 10 (12.8%) patients. In group 2, cholecystectomy was performed on days 4–7. Inflammatory changes were revealed in 13 (37.1%) preparations. Pathological examination of the surgical specimens of the patients in group 3 who underwent cholecystectomy on days 14–30 revealed changes in the gallbladder wall in 48 (56.4%) cases.

CONCLUSIONS: Laparoscopic cholecystectomy after endoscopic bile duct decompression within the first 72 h is the most optimal.

Keywords

gallbladder morphology / complicated cholelithiasis / endoscopic bile duct drainage

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