[Treatment of recurrence and complications following non-surgical management of cholelithiasis].

The authors performed cholecystectomy on 9 patients either while on oral BAT, or after the termination of oral BAT. Five cases of the operation were due to hydrops, 3 cases due to obstructive cholecystitis, and one case due to contraction of the gallbladder in the absence of gallstones. Two patients underwent operation after PTCL, while one patient was operated on after ESWL. In all 12 cases serious adhesions were noticed around the gallbladder. Cholecystectomy was made complicated by the fact that in 11 cases there was cicatrized thickening of the wall of the gallbladder: one of the cases was even coupled with Mirizzi syndrome. After ESWL, the wall of the gallbladder did not thicken, however the adhesions left impressions on the hepatic duct which caused diagnostic problems. In ten cases, micro-, and in two cases mini-laparotomy was employed. The patients were discharged from hospital 24-72 hours after cholecystectomy. It is obvious that after the non operative treatment of cholelithiasis, with the preservation of the gallbladder, the reoccurrence of the gallstones is always coupled with complications which then render cholecystectomy more difficult to perform. In such cases the gallbladder is much more safely removed by employing micro- and modern mini-laparotomy.