Feasibility of transgastric endoscopic gallbladder-preserving surgery for benign gallbladder diseases (with video)

Surg Endosc. 2022 Apr;36(4):2705-2711. doi: 10.1007/s00464-021-08890-4. Epub 2022 Jan 24.

Abstract

Background: With the increasing realization of the importance of gallbladder function, choledochoscopic gallbladder-preserving surgery has been advocated for benign gallbladder diseases. However, limited information is available regarding the use of endoscopic gallbladder-preserving surgery (EGPS) for patients with benign gallbladder diseases. The aim of this study was to evaluate the feasibility of EGPS for benign gallbladder diseases.

Methods: Between June 2020 and January 2021, 22 patients with gallbladder stones and/or gallbladder polyps were treated with EGPS. The main outcome measures included the rate of complications, residual gallbladder stones, and gallbladder stone recurrence.

Results: In this study, transgastric EGPS was successfully performed in 22 patients (13 female, 9 male) with benign gallbladder diseases, and included 8 cases of multiple gallstones, 4 cases of gallbladder polyps with gallstones, 6 cases of multiple gallbladder polyps, 2 cases of single gallstone, and 2 case of singe gallbladder polyp. The median time of transgastric EGPS was 118 min. During hospitalization, 4 patients suffered localized peritonitis (4/22, 18.2%), and these patients successfully recovered after conservative medical treatment. None of the patients experienced massive bleeding, delayed bleeding, diffuse peritonitis, or any other serious complications. During the median follow-up of 4 months, 1 patient suffered residual gallstone, while no gallstone recurrence or deaths related to transgastric EGPS occurred in any patients.

Conclusions: Transgastric EGPS appears to be a feasible treatment method in selected patients with benign gallbladder diseases. However, as it is a new technique, further studies are needed to explore the long-term effectiveness of transgastric EGPS.

Keywords: Endoscopic gallbladder-preserving surgery; Gallbladder polyp; Gallbladder stone; Natural orifice transluminal endoscopic surgery.

Publication types

  • Research Support, Non-U.S. Gov't
  • Video-Audio Media

MeSH terms

  • Feasibility Studies
  • Female
  • Gallbladder / surgery
  • Gallbladder Diseases* / diagnostic imaging
  • Gallbladder Diseases* / pathology
  • Gallbladder Diseases* / surgery
  • Gallstones* / diagnostic imaging
  • Gallstones* / surgery
  • Humans
  • Male
  • Peritonitis*
  • Polyps* / pathology
  • Polyps* / surgery