A Six-Year Retrospective Follow-up of 502 Patients with Laparoscopic Cholelithotomy for Gallstone Recurrence: Success or Prospect

Background This research was designed to explore the risk factors for gallstone recurrence after laparoscopic cholelithotomy. Methods A total of 502 patients who were diagnosed with gallstones using ultrasonography underwent laparoscopic cholelithotomy between January 2011 and December 2017 at the Shanghai-East Affiliated Hospital of Tongji University. Results Our retrospective study revealed that the gallstone recurrence rate of patients taking tauro-ursodeoxycholic acid (TUDCA) was significantly lower (P<0.05) than that of patients not taking TUDCA. The recurrence rate of gallstones in patients with an incision at the fundus of the gallbladder was significantly lower than that of the patients with an incision on the body of the gallbladder. The risk of recurrence in patients with gallstones combined with polyps was significantly higher than that in patients without polyps; the risk of recurrence of gallstones in patients with gallbladder contraction function < 50% was significantly higher than that in patients with gallbladder contraction function ≥ 50%. Additionally, the prognosis of patients without gallbladder adhesions to the peritoneum was better than that of patients with adhesions. Conclusion During the 6-year follow-up period of this study, the recurrence rate of gallstones after laparoscopic gallbladder-preserving cholelithotomy (LGPC) was 22.91%. Factors related to gallstone recurrence were use of TUDCA, location of the incision, presence of gallstones combined with polyps, gallbladder contraction function and presence of gallbladder adhesions to the peritoneum. The main cause of gallstone recurrence needs further investigation, and laparoscopic cholelithotomy remains promising for treatment of gallstone recurrence but requires thorough follow-up.