Surgical Endoscopy

, Volume 28, Issue 3, pp 910–917 | Cite as

Routine cholangiography during rigid-hybrid transvaginal natural orifice transluminal endoscopic cholecystectomy

  • Önder Ögredici
  • Georg R. Linke
  • Sebastian Lamm
  • Rachel Rosenthal
  • Andreas Zerz
  • Daniel C. Steinemann
Article
First Online:
Received:
Accepted:

Abstract

Background

Transvaginal rigid-hybrid transluminal endoscopic cholecystectomy (tvCCE) has become a routine procedure in some laparoscopic departments in recent years. Although intraoperative cholangiography is an important adjunct to cholecystectomy, its feasibility and safety in tvCCE have not been demonstrated to date.

Methods

Patients undergoing tvCCE between April and October 2012 were included in this study. An intraoperative cholangiogram was obtained routinely for all the patients. Patient characteristics, operation data, feasibility, and duration of the cholangiography as well as the postoperative course were recorded prospectively.

Results

For 32 (97 %) of the 33 patients enrolled in this study, intraoperative cholangiography could be performed successfully. The median duration of cholangiography was 6 min (interquartile range, 4–7 min). Common bile duct stones were detected in three patients (10 %). Laparoscopic bile duct revision with the aid of one additional port was successful in two of these patients. One patient needed postoperative endoscopic retrograde cholangiopancreatography due to the impossibility of extracting an impacted prepapillary concrement. One operation was converted to a four-port laparoscopic cholecystectomy. One additional port was used in 11 patients (33 %) and two additional ports in three patients (9 %). Three intraoperative minor complications (9 %) and one postoperative minor complication (3 %) occurred.

Conclusions

Intraoperative cholangiography during tvCCE is feasible, safe, and easy to perform. The need for intraoperative cholangiography no longer represents a contraindication for tvCCE.

Keywords

Transvaginal Hybrid Cholecystectomy Intraoperative cholangiography NOTES 
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Notes

Disclosures

Önder Ögredici, Georg R. Linke, Sebastian Lamm, Rachel Rosenthal, Andreas Zerz, and Daniel C. Steinemann have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Önder Ögredici
    • 1
    • 2
  • Georg R. Linke
    • 3
  • Sebastian Lamm
    • 1
  • Rachel Rosenthal
    • 4
  • Andreas Zerz
    • 1
  • Daniel C. Steinemann
    • 1
  1. 1.Department of SurgeryKantonsspital BasellandBruderholzSwitzerland
  2. 2.Department of SurgeryKantonsspital St. GallenSt. GallenSwitzerland
  3. 3.Department of General, Visceral and Transplantation SurgeryUniversity Hospital HeidelbergHeidelbergGermany
  4. 4.Department of Visceral SurgeryUniversity Hospital BaselBaselSwitzerland

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