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

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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.

作者简介

Alexey Shabunin

Botkin Hospital; Russian Medical Academy of Continuous Professional Education

Email: info@botkinmoscow.ru
ORCID iD: 0000-0002-4230-8033
SPIN 代码: 8917-7732

MD, Dr. Sci. (Med.), Professor, Corresponding member of the Russian Academy of Sciences

俄罗斯联邦, 5, 2nd Botkinsky passage, Moscow, 125184; Moscow

Mikhail Tavobilov

Botkin Hospital; Russian Medical Academy of Continuous Professional Education

Email: botkintmm@yandex.ru
ORCID iD: 0000-0003-0335-1204
SPIN 代码: 9554-5553

MD, Dr. Sci. (Med.), assistant professor

俄罗斯联邦, 5, 2nd Botkinsky passage, Moscow, 125184; Moscow

Alexey Karpov

Botkin Hospital

Email: botkin.karpov@yandex.ru
ORCID iD: 0000-0002-5142-1302
SPIN 代码: 9877-4166

MD, Cand. Sci. (Med.)

俄罗斯联邦, 5, 2nd Botkinsky passage, Moscow, 125184

Darya Ozerova

Botkin Hospital; Russian Medical Academy of Continuous Professional Education

编辑信件的主要联系方式.
Email: ozerova311@yandex.ru
ORCID iD: 0000-0003-4996-5025

surgeon emergency department №75, graduate student of Surgery Department RMACPS

俄罗斯联邦, 5, 2nd Botkinsky passage, Moscow, 125184; Moscow

参考

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2. Fig. 1. Histopathological image of acute catarrhal cholecystitis, hematoxylin and eosin stain, 10×.

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3. Fig. 2. Histopathological image of acute suppuration cholecystitis, hematoxylin and eosin stain, 10×.

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4. Fig. 3. Histopathological image of acute gangrenous cholecystitis. The thickness of the gallbladder wall: a — 2.7–3.0 mm; b —1.0–1.3 mm. Hematoxylin and eosin stain, 10×.

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