Transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic surgery: Retrospective 7-case series on patients with cholecystolithiasis

Abstract Background Cholelithiasis is a common disease. It is worthy exploring the efficacy and safety of absorbable cllips in transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic surgery. Method A retrospective analysis was performed on the clinical data of 7 patients undergoing transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic surgery in Department of Gastroenterology, Guangxi Zhuang Autonomous Region People's Hospital from August 2020 to August 2021. Result The 7 patients were successfully operated. The operation time was 121 ~ 275min. The intraoperative blood loss was 0 ~ 25ml. The number of absorbable clips used during the operation was 4 ~ 10. The closure time of gallbladder was 29 ~ 93min. The time of first anal exhaust or defecation after operation was 24 ~ 36h. Slight postoperative pain occurred in 2 cases, which could be relieved by themselves. The length of patient stay was 6 ~ 10 days. No postoperative fever occurred in all patients and no complications such as bile leakage and poor closure occurred during hospitalization. The gallbladder function of 7 patients was evaluated by ultrasound or CT during six months follow-up. Among them, 1 case was found residual stones and 1 case was found stone recurrence. Conclusion Transumbilical gallbladder-preserving lithotomy via natural orifice transluminal endoscopic surgery is safe and feasible. Besides, the use of absorbable clips in gallbladder incision is innovative and effective in clinical practice.