Gallstone Disease
Conditions
Keywords
transvaginal, NOTES, cholecystectomy, cholangiography, symptomatic gallstone disease
Brief summary
While gold standard in the treatment of symptomatic gall stones is laparoscopic cholecystectomy with instruments introduced through multiple abdominal wall incisions, transvaginal access to the peritoneal cavity offers an alternative avoiding injury of the abdominal wall. Transvaginal hybrid-NOTES cholecystectomy has been demonstrated effective and safe. However it has not been demonstrated up-to-date if intraoperative cholangiography is feasible during such procedure. This observational case series describes success and technical feasibility of intraoperative cholangiography during transvaginal cholecystectomy. The investigators hypothesis is that cholangiography is feasible equal to conventional laparoscopic cholecystectomy.
Interventions
PROCEDURECholangiography during transvaginal rigid-hybdrid NOTES cholecystectomy
During transvaginal rigid-hybrid NOTES cholecystectomy a intraoperative cholangiography is performed. After dissection of the Calot's triangle and distal clipping of the cystic duct, the cystic duct is incised and a regular cholangiography catheter is inserted. Contrast is injected and an image is obtained using an image-converter. After extraction of the catheter the cystic duct is clipped proximally. This intervention is performed in all patients included in the study.
Sponsors
Cantonal Hosptal, Baselland
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* symptomatic gallstone disease * age \> 18 years * written informed consent
Exclusion criteria
* age \< 18 years * not able to understand informed consent * pregnancy * vaginal atresia * florid vaginal infection * gynecological neoplasia * allergy to Iod * missing informed consents * emergency procedure
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with successful introduction of cholangiography catheter into cystic duct (yes/no) | intraoperative | Was the introduction of the cholangiography catheter into the cystic duct successfull during transvaginal rigid-hybrid cholecystectomy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time required for cholangiography | intraoperative | From incision of the cystic duct to clipping of the cystic duct |
| Intraoperative complications | intraoperative | — |
| postoperative complications | within 6 weeks from surgery | — |
Countries
Switzerland
Outcome results
None listed