SURGICAL-TREATMENT OF SYMPTOMATIC BILIARY STONES IN PATIENTS WITH CYSTIC-FIBROSIS

Patients with cystic fibrosis have a high incidence of cholelithiasis. However, few studies have addressed the operative therapy for choleli thiasis in this group of patients with poor pulmonary function. We rev iewed six patients with cystic fibrosis who were treated for symptomat ic biliary stones. Five patients underwent cholecystectomy for chronic cholecystitis. One patient with extremely poor pulmonary status prese nted with choledocholithiasis and cholangitis, which was successfully treated with endoscopic sphincterotomy followed by ursodeoxycholic aci d therapy. Five of these six patients had significant relief of their symptoms. One patient never recovered completely from the operation an d eventually died from continued pulmonary deterioration. We conclude that in patients with cystic fibrosis and symptomatic biliary stones, careful attention to pulmonary care can afford safe, elective cholecys tectomy. More conservative treatment is indicated in patients with mar ginal pulmonary reserve.