J Korean Soc Transplant.  2014 Sep;28(3):160-164. 10.4285/jkstn.2014.28.3.160.

Management of Asymptomatic Gallstones in Renal Transplantation

Affiliations
  • 1Hepato-Biliary-Pancreas Center and Division of Transplantation, Department of General Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea. surgeonshin@naver.com

Abstract

BACKGROUND
In solid organ transplantation patients, complications of cholelithiasis may run a fulminant course, resulting in high morbidity and mortality under immunosuppression and may even result in rejection. Here, we reviewed medical records of 66 patients in order to determine the outcome of management approach for asymptomatic gallstones in renal transplantation patients.
METHODS
We retrospectively reviewed clinical courses of 66 cases of renal transplantation performed between 2000 and 2012 at Kosin University Gospel Hospital.
RESULTS
Among 66 cases, eight had gallstones before transplantation. Three of these cases had undergone previous cholecystectomy for symptomatic gallstones, one had a simultaneous laparoscopic cholecystectomy and renal transplantation, and four were observed by regular abdominal ultrasonography. One patient was found to have cholangitis, and endoscopic retrograde biliary drainage was performed, resulting in alleviation of symptoms. Among 58 cases without preoperative gallstones, three developed gallstones after transplantation. One patient had cholecystitis, and the symptoms subsided after conservative treatment.
CONCLUSIONS
For patients with asymptomatic gallstones who are awaiting renal transplantation, expectant management should be considered.

Keyword

Kidney transplantation; Prophylactic laparoscopic cholecystectomy; Gallstones
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