Laparoendoscopic single-site cholecystectomy and common bile duct exploration using conventional instruments

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Surgical Innovation

Background:

• Optimizing quality of life is a key goal in advanced surgical procedures.
• Common bile duct (CBD) stones necessitate effective management strategies.
• Scarless surgical techniques aim to reduce patient morbidity and improve cosmetic outcomes.

Purpose of the Study:

• To demonstrate the feasibility of scarless laparoendoscopic single-site (LESS) common bile duct (CBD) exploration.
• To evaluate the use of conventional laparoscopic instruments in LESS CBD stone management.
• To assess the safety and efficacy of LESS cholecystectomy and CBD exploration.

Main Methods:

• Fifteen patients with CBD stones underwent transumbilical LESS cholecystectomy and CBD exploration.
• Preoperative or intraoperative endoscopic nasobiliary drainage (ENBD), endoscopic retrograde biliary drainage (ERBD), or J-type tubes were utilized.
• A single 2-cm umbilical incision accommodated three trocars for conventional rigid laparoscopic instruments.

Main Results:

• All procedures were completed successfully with a mean operative time of 125.7 minutes.
• Three patients experienced pigtail J-tube displacement, with all tubes passed uneventfully in stool.
• No major complications were reported during the procedures.

Conclusions:

• Laparoendoscopic single-site cholecystectomy and CBD exploration is a technically feasible alternative to standard laparoscopic surgery.
• Conventional laparoscopic instruments can be effectively employed for LESS CBD procedures.
• Laparoscopic primary closure combined with preoperative ENBD/ERBD and intraoperative J-tubes is a safe and viable approach.