A new innovative technique to preserve gallbladder function in patients with the polypoid lesions of the gallbladder

Background: Gallbladder polyps are frequently discovered in recent years. If polyps are benign and the gallbladder has a good function, there is no absolute indication for cholecystectomy. Thus, a procedure for percutaneous cholecystoscopic polypectomy of the gallbladder polyps was developed and applied. Patients and Methods: 85 patients with gallbladder polyps who underwent percutaneous endoscopic polypectomy were studied. Under epidural anesthesia, a minilaparotomy (2.5-3.0 cm) was performed subcostly in the right upper quadrant, and the gallbladder fundus was then pulled out of the abdominal cavity with a grasping forceps. A rigid or flexible cholecystoscope was introduced into the gallbladder. The polyp stalk or the basement mucosa of the polyps was coagulated using a self-made microwave coagulator, then the polyps were removed for histopathological evaluation. The preserved gallbladder was followed up to evaluate the efficacy of this gallbladder-preserving technique. Results: All procedures were uneventful, with a mean operation time of 1 h. 67 patients were followed up for a mean of 5.5 years (range 2-9 years). 64 patients were symptom-free, and their gallbladder function was found to be well preserved, without recurrence of polyps and occurrence of gallstones on ultrasonography. The other 3 patients had mild upper abdominal discomfort, and their gallbladder function proved to be insufficient with additional gallstone formation. Their gallbladders were removed laparoscopically. Conclusion: The minimal invasive procedure reported here is reliable, simple, and applicable to remove gallbladder polyps and to preserve gallbladder function in patients with benign gallbladder polyps.