이식환자에서의 복강경 담낭절제술

Abstract

Background: Nowadays the laparoscopic cholecystectomy has become the standard mode of operation in the indications of acute and chronic cholecystitis. The laparoscopic cholecystetcomy in immune-compromized transplanted patients is still thought to be a high-risk procedure, although there is no definite statistical report that confirms this prejudice. Methods: We analyzed the clinical data of 8 transplanted patients (7 renal transplanted and 1 heart transplanted) that underwent laparoscopic cholecystectomy from January 1991 to December 1998 in Shinchon Severance Hospital of Yonsei University, and tried to report the follow-up results of treatments and check the possible risk factors during and after operation with a referring review of literature. Results: All patients underwent laparoscopic cholecystectomy in conventional method with pneumoperitoneum and four trocar site punctures. Among them four patients had symptoms of acute or chronic cholecystitis. Except one patient they had all normal graft function and discharged as usual without any complication. There was case of mortality that was due to postoperative uncontrollable biliary sepsis caused from bile leakage. Conclusion: Laparoscopic cholecystectomy in transplant patients can be a treatment of choice with regards to its safety and effectiveness. Because the development of complication in the immume-compromized transplant patients can cause severe clinical results, prophylactic cholecystectomy in asymptomatic patients would be an appropriate measure.