Gallbladder Stones, Cholecystitis and Cholecystectomy in Patients on Continuous Ambulatory Peritoneal Dialysis

This paper describes a prospective three-year study using abdominal ultrasound examination in 114 new CAPD patients. Gallbladder disease was common (22.8%) and four of 16 patients with gallstones (25%) required cholecystectomy after 1–14 (i 7.8 months) on CAPD. Two of these four had evidence of peritonitis in association with cholecystitis. Also we analyzed the clinical course of eight patients on chronic PD who underwent cholecystectomy. They had no serious morbidity, and all returned to chronic PD. While abdominal pain is one of the main features of CAPD-related peritonitis, other causes of abdominal pain may be more difficult to evaluate in the patient on peritoneal dialysis (PD); such causes potentially are more serious because they threaten the continuance of PD as a mode of therapy. Cholecystitis related to cholelithiasis is one such possible cause of abdominal pain. However, since ultrasonography can reliably and non-invasively detect the presence of gallstones, we have used it prospectively to screen patients entering our CAPD training program. This paper reports our findings and the subsequent course of those found to have gallstones during a three-year period. In addition we also reviewed the feasibility of cholecystectomy, its hazards and outcome in eight patients on chronic peritoneal dialysis who underwent this procedure at Toronto Western Hospital in the past seven years.