Abstract
We evaluated the effectiveness of interventional radiology (IVR) in combination with laparoscopic cholecystectomy (LC). Between November 1996 and September 2002, LC following percutaneous papillary balloon dilatation (PPBD) was performed in 43 patients for the treatment of cholecystocholedocholithiasis with cholangitis, and LC following percutaneous transhepatic gallbladder drainage (PTGBD) was performed in 36 patients for the treatment of acute cholecystitis. In 17 patients, PPBD following percutaneous transhepatic biliary drainage was performed 2 to 7 days prior to the LC, while in the remaining 26 patients, PPBD was performed simultaneously with the LC under a general anesthesia with the use of a muscle relaxant in one continuous session. The bile duct stones were successfully expelled into the duodenum in all the patients. The conversion to open surgery rate, the mean operative time for the LC and the average postoperative hospital stay were 0%, 73 minutes, and 11 days, respectively. PTGBD was performed 1 to 7 days prior to the LC. The success rate of the intraoperative cholangiography through the PTGBD tube, the conversion to open surgery rate, the mean operative time for the LC and the mean postoperative hospital stay were 97%, 3%, 82 minutes, and 10 days, respectively. We conclude that LC combined with IVR is an effective therapeutic option for cholecystocholedocholithiasis with cholangitis and acute cholecystitis.
