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The role of cholecystectomy in renal transplantation.
Transplantation Proceedings 2005 June
INTRODUCTION: We reviewed our clinical experience to assess the role of cholecystectomy transplant candidates pre- and posttransplantation.
METHODS: Between April 1986 and December 2003, 57 (6.8%) candidates among 839 kidney transplants were found during routine pretransplant screening to show gallstones.
RESULTS: Thirty nine (68.4%) symptomatic patients underwent cholecystectomy before transplantation. Among 18 (31.6%) asymptomatic patients monitored after transplantation, the 7 (39%) who developed biliary tract symptoms underwent laparoscopy or minilaparocholecystectomy without postoperative morbidity, mortality, or graft loss.
CONCLUSIONS: Symptomatic gallstones have to be treated using the laparoscopic cholecystectomy or minilaparotomy technique. In asymptomatic cholelithiasis prophylactic cholecystectomy is only reserved for patients with biliary "intrinsic" risk factors. An early diagnosis and prompt surgical treatment yields good results.
METHODS: Between April 1986 and December 2003, 57 (6.8%) candidates among 839 kidney transplants were found during routine pretransplant screening to show gallstones.
RESULTS: Thirty nine (68.4%) symptomatic patients underwent cholecystectomy before transplantation. Among 18 (31.6%) asymptomatic patients monitored after transplantation, the 7 (39%) who developed biliary tract symptoms underwent laparoscopy or minilaparocholecystectomy without postoperative morbidity, mortality, or graft loss.
CONCLUSIONS: Symptomatic gallstones have to be treated using the laparoscopic cholecystectomy or minilaparotomy technique. In asymptomatic cholelithiasis prophylactic cholecystectomy is only reserved for patients with biliary "intrinsic" risk factors. An early diagnosis and prompt surgical treatment yields good results.
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