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

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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.

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About the authors

Alexey V. Shabunin

Botkin Hospital; Russian Medical Academy of Continuous Professional Education

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

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

Russian Federation, 5, 2nd Botkinsky passage, Moscow, 125184; Moscow

Mikhail M. Tavobilov

Botkin Hospital; Russian Medical Academy of Continuous Professional Education

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

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

Russian Federation, 5, 2nd Botkinsky passage, Moscow, 125184; Moscow

Alexey A. Karpov

Botkin Hospital

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

MD, Cand. Sci. (Med.)

Russian Federation, 5, 2nd Botkinsky passage, Moscow, 125184

Darya S. Ozerova

Botkin Hospital; Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: ozerova311@yandex.ru
ORCID iD: 0000-0003-4996-5025

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

Russian Federation, 5, 2nd Botkinsky passage, Moscow, 125184; Moscow

References

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  2. Bostanci EB, Ercan M, Ozer I, et al. Timing of elective laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreaticography with sphincterotomy: a prospective observational study of 308 patients. Langenbecks Arch Surg. 2010;395(6):661–666. doi: 10.1007/s00423-010-0653-y
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Supplementary files

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

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

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3. 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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Свидетельство о регистрации СМИ № 01016 от 19.07.1995 г. выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор). 
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