ABSTRACT:
This study investigates the clinical outcomes of minimally invasive laparotomic cholecystolithotomy, aimed at removing gallstones while preserving the anatomical structure and physiological functions of the gallbladder. The focus is on evaluating the effectiveness of this organ-preserving approach in the treatment of cholelithiasis (LC) within a private clinical practice in Kazakhstan, with particular attention to pharmacological interventions that support recovery and prevent complications. The study involved 189 patients aged 20 to 75 years, who underwent surgery after a thorough ultrasound examination, with magnetic resonance cholangiopancreatography used in selected cases. The success rate of the procedures was 98.9%, and the functional activity of the gallbladder was restored in 100% of patients within six months. Postoperative pharmacological therapies, including bile acid sequestrants and ursodeoxycholic acid, were administered to enhance bile flow and prevent recurrent stone formation. One patient (0.53%) experienced gallbladder wall suture failure, and four patients (2.12%) required additional intervention for residual stones. Post-surgical ultrasound revealed significant reduction in gallbladder wall thickness, and 94% of patients reported improved quality of life. The results suggest that minimally invasive cholecystolithotomy, when combined with appropriate pharmacological treatments, is a viable alternative to traditional cholecystectomy, particularly for patients with high surgical risks or those requiring organ preservation.