Controversy and Consensus of reserve or removal gall bladder for Chronic Cholecystitis and Gallstone

LU Qi-ping

doi:10.7504/CJPS.ISSN1005-2208.2015.01.15

Abstract：Cholecystectomy has been used for hundreds of years as the standard treatment model of the disease. The therapeutic principle that“Removal the pathology gallbladder with stone with the addition of managing complications outside the gall bladder properly should be the standard treatment, except implement gallbladder fistula operation for acute cholecystitis in case of emergency”performed by academician Huang Zhi-qiang has reached a consensus in biliary tract surgery field.“Cholelithotomy ”or“cholecystectomy ”is the focus of discussion for nearly a decade. There are still no standards for indication and technical operation, especially the problem of postopreation recurrence of stone is not resolve successfully yet, so cholelithotomy should not widely carried out in the absence of large amount of prospective study to confirm the exact curative effect. Which is recommended only on condition of clinical symptoms mild, gall bladder function is well , no family history of metabolic syndrome, elderly in emergency and patients with high-risk. While the former should pay attention to take effective measures to prevent the postoperative recurrence of stones, and ready for cholecystectomy; the latter is only for patients who can’t tolerate emergency cholecystectomy, and elective cholecystectomy should be performed after remission. Relevant clinical and basic researches should move forward under the idea of precise surgery. At the same time, relevant clinical and basic research should be further strengthened, and improve the technology management of surgical treatment for chronic cholecystitis and gallstone disease needs to be improved further.