Objective:To investigate the efficacy of minimally invasive endoscopic cholecystolithotomy with gallbladder preservation and cholecystectomy for gallstons, and analyze the incidences of postoperative complications and adverse reactions.
Methods:Patients with cholelithiasis undergoing gallbladder-preserving surgery or cholecystectomy in 11 hospitals from October 2009 to June 2010 were followed up. The incidences of all postoperative complications and adverse reactions were investigated.
Results:Actually, 10 449 patients were involved in this follow-up investigation, of which 3699 cases underwent gallbladder-preserving surgery and 6750 cases underwent cholecystectomy. Except for a 9.76% recurrence rate of gallstone, the incidences of the remaining complications and adverse reactions (biliary tract disorder, extrahepatic bile duct injury, bile leakage, postoperative intestinal obstruction, extrahepatic bile duct stone, colon cancer, postoperative diarrhea, reflux gastritis and reflux esophagitis) in the gallbladder-preserving surgery group were all significantly lower than those in the cholecystectomy group (0.84% vs. 11.5%, 0 vs. 0.61%, 0.03% vs. 1.90%, 0.27% vs. 2.01%, 1.65% vs. 5.67%, 0.16% vs. 0.84%, 1.95% vs. 12.19%, 2.14% vs. 5.72%, 1.03% vs.3.84%, respectively) (all P＜0.01).
Conclusions:Minimally invasive endoscopic cholecystolithotomy with gallbladder preservation is a safe and effective procedure due to its fewer postoperative complications and low recurrence rate. Postoperative diarrhea is the major adverse reaction after cholecystectomy that may, however, provide insights into treatment strategies for those with functional constipation.