SURGICAL THERAPY FOR 101 PATIENTS WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME AND SYMPTOMATIC CHOLECYSTITIS

BACKGROUND: Hepatobiliary disease in patients with acquired immunodefi ciency syndrome (AIDS) has been well documented. Cytomegalovirus and C ryptosporidium are the pathogens most frequently associated. Previous reports of cholecystectomies and AIDS have had conflicting results on morbidity and mortality. METHOD: Retrospective review of 101 patients with AIDS and symptomatic cholecystitis who underwent cholecystectomy from December 1989 to May 1995. RESULTS: All patients had symptoms cha racteristic of gallbladder disease, the most common being abdominal pa in and fever. Thickening of the gallbladder was the most common diagno stic finding. Fifty-six patients underwent open cholecystectomy and 45 laparoscopic cholecystectomy. Pathologic examination revealed an abno rmal gallbladder in all cases and gallstones in 29%. A specific pathog en or malignancy was identified as the etiologic agent in 44% of patie nts. Perioperative morbidity was similar (< 5%) in both surgical group s. Perioperative mortality was 4% among all the patients treated. CONC LUSIONS: Both open and laparoscopic cholecystectomy improved the quali ty of life of these patients and should be considered as the treatment for persistent hepatobiliary symptoms in patients with AIDS. (C) 1997 by Excerpta Medica, Inc.