Gallstone recurrence and gallbladder function following percutaneous cholecystolithotomy.
PURPOSE: To determine the frequency of recurrent symptoms and gallstones following successful percutaneous cholecystolithotomy (PCCL) and to evaluate the effect of the procedure on gallbladder function. PATIENTS AND METHODS: Between 1988 and 1991, 32 patients underwent successful PCCL for the treatment of symptomatic gallstones. Outcome was assessed clinically (mean follow-up, 24 months) in 31 patients and by means of serial ultrasound examination (mean follow-up, 26 months) in 23 patients. RESULTS: Symptomatic relief following the procedure was good, with only five of 31 patients (16%) experiencing recurrent symptoms during the follow-up period. Eight patients died of unrelated causes with no recurrence of symptoms. Nine (39%) of the remaining 23 patients have either retained gallstone fragments (four patients [16%]) or recurrent gallstones (five patients [22%]). Gallbladder motility was studied after PCCL in 10 patients, including four with retained or recurrent stones, and nine gallbladders were shown to be functioning well. CONCLUSION: PCCL is a useful treatment for symptomatic gallstones in patients at high risk for surgery. It preserves gallbladder function, but recurrent gallstones are a significant problem.