Transumbilical Single-Incision Laparoscopic Choledocholithtomy Using Conventional Instruments: The First Five Cases

Wu Shuo-Dong, Tian Yu, Chen Yong-Sheng, Su Yang, Chen Chun-Chih. Department of Biliary and Vascular Surgery, Shengjing Hospital, China Medical University

Background/aim: Optimization of quality of life (QOL) is an important goal in the advanced surgery. Herein we share our five cases to demonstrate the feasibility of scarless transumbilical single-incision laparoscopic choledocholithtomy using conventional instruments in the management of common bile duct stones.

Cases and Methods: Five patients (1 male) underwent transumbilical single-incision laparoscopic choledocholithtomies: the patients were diagnosed with common bile duct stones. The ENBD, ERBD or J-type tube was introduced into the common bile duct preoperatively or intraoperatively. A 2-cm periumbilical incision was made for the placement of three trocars. Conventional rigid laparoscopic instruments were solely used throughout the procedure, and operative techniques were carried out in the same fashion as for conventional laparoscopic choledocholithtomy.

Results: The procedures were completed uneventfully in the mean duration of 105 minutes, and the blood loss was estimated at 65ml. Postoperative pain scores on postoperative day 1 were 3.6/10. One patient occurred abdominal cavity empyema and was cured reoperatively.

Conclusions: Transumbilical single-incision laparoscopic choledocholithtomy appears to be a technically feasible alternative to standard laparoscopic procedure, and can be performed using conventional laparoscopic instruments.