Transrectal gallbladder preserving cholecystolithotomy and polypectomy by pure notes

Transrectal gallbladder preserving cholecystolithotomy and polypectomy by pure notes

Joint Event on World Gastroenterological & World Congress on Gastroenterology and Endoscopy
October 30-31, 2017 | Toronto, Canada

Bingrong Liu

Zhengzhou University, China

Abstract:

Introduction: We conducted this retrospective study aiming to evaluate the feasibility and efficacy of transrectal gallbladder preserving cholecyctolithotomy (TRGPC) and transrectal gallbladder preserving polypectomy (TRGPP) by pure notes. Methods: 30 cases underwent transrectal gallbladder preserving cholecyctolithotomy (TRGPC), 4 patients received transrectal gallbladder preserving polypectomy (TRGPP) and 6 cases underwent combined transrectal gallbladder preserving cholecyctolithotomy and polypectomy by pure NOTES and one patient was performed by hybrid NOTES. As the figures show, the balloon was placed in the transverse colon to block the colonic lumen, and the distal colon cavity was disinfected with povidone-iodine solution. An incision was made on the anterior rectal wall 15-20cm from the anus. The endoscope was advanced into the peritoneal cavity with liver and gallbladder identified. The bile was aspirated and an incision on the gallbladder wall was made. Stones and/or polyps were found inside of the gallbladder.Stone extractor and biopsy forceps were used to take out the stones. The polyps were coagulated and removed by electric biopsy forceps. The muscular layer and the adventitial layer were successively closed with endoclips. The rectal incision was closed with endoclips and endoloops tightly. At the end of the procedure, the balloon was pulled out after being deflated. Results: The mean operation time was 180.5 min. (89-467min.). liquid diet was resumed 24 hours later. Postoperatively, 4 of the 41 patients felt mild abdominal distention which disappeared within 12 hours when they were able to get off the bed. Moreover, gallbladder drainage and peritoneal lavage were used, and the abdominal pain relieved soon. All the patients were discharged without any adverse events. Conclusions: The usage of the detachable balloon can prevent the operative field from fecal contamination effectively. To our knowledge, this is the first human case series of transrectal gallbladder preserving cholecyslithotomy and polypectomy by pure notes.

Biography:

Bingrong Liu is a Doctor of Medicine, Post doctor, Professor, Doctoral supervisor and President of the GI Hospital, The First Affiliated Hospital of Zhengzhou University. He initiated the painless gastroenteroscopic examinations in 2002 in the three northeast provinces. And has been engaged in the work of interventional treatment of liver cancer and achieved a good result. He and his team has initiated and completed a series of pioneering techniques in the world in recent years. Every year since 2010, Professor Bingrong Liu has shown himself at different international conferences as a speaker, and has been invited by many countries to carry out academic reports and demonstrations. He enjoys a high reputation both at home and abroad. In 2015, his work on the Transrectal Gallbladder-Preserving Cholecystolithotomy via Pure NOTES” won the eightieth American Digestive Association (ACG) video contest champion.

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