A New Exploration for Gallbladder Polyps: Gallbladder Polypectomy by Endolap Technique

Abstract

Gallbladder polyps are most commonly treated with cholecystectomy, which is associated with various complications. For benign disease, preserving the gallbladder is preferable. Since 1994, we have been exploring percutaneous polypectomy and have recently developed an improved new technique. This study reports a new endoscopic-laparoscopic (Endolap) technique for the removal of polyps and the preservation of the gallbladder. Nine Chinese mini-pigs were used to observe mucosal regeneration. Microwaves of 50-70 mA for 9 seconds were safe, and the gallbladder mucosa of pigs recovered to nearly normal 2 weeks later. In the clinical cases, 60 patients with gallbladder polyps were studied. With the patient under general anesthesia, each polyp stem was coagulated, and then the polyp was removed. All procedures were successful at between 60 and 135 minutes. The success rate was 93.33% (56/60). A retrospective analysis was conducted to assess the recovery of gallbladder function. All patients were followed up and symptom-free, without recurrence of the polyps; 3 months after the operation, the volume and contraction of the gallbladder recovered to preoperative levels. Thus the Endolap technique is reliable for removing benign gallbladder polyps and is applicable to a wider range of clinical situations than percutaneous polypectomy.

Gallbladder-preserving polypectomy for gallbladder polyp by embryonic-natural orifice transumbilical endoscopic surgery with a gastric endoscopy

“…Secondly, the lesion can be completely removed to reduce gallbladder cancer risk, and the pathological diagnosis of polyps can be obtained to develop further treatment or follow-up strategies. Thirdly, compared with traditional laparoscopic-assisted gallbladder-preserving polypectomy [ 13 , 22 , 23 ], the main advantage of E-NOTES is that the umbilical cord is the weakest part of the abdominal wall, and transumbilical puncture can not only reduce the injury of the abdominal wall, but also relieve the pain of the surgical wound. Furthermore, the 2–4 incisions in the abdomen of the traditional laparoscopic surgery can be transformed into a small incision of 10 mm in the umbilical cord.…”

“…The gallbladder-emptying function was expressed by the gallbladder emptying index: (fasting volume—postprandial volume)/ fasting volume × 100%. The gallbladder-emptying function was good, acceptable, poor respectively when the gallbladder emptying index were more than 50%, 33.3% to 50%, less than 33.3% [ 13 ].…”

Management Strategy for Gallbladder Polypoid Lesions: Results of a 5-Year Single-Center Cohort Study

“…Recently, the surgical technique of laparoscopic-choledochoscopic polypectomy has been reported to remove polyps but preserve the gallbladder [5, 9]. Preservation of a functional gallbladder is important for humans.…”

“…Minimally invasive gallbladder-preserving cholecystolithotomy (GPC) has been applied in the treatment of patients with a small number of stones, with little morbidity and few recurrences [7, 8]. A surgical technique of laparoscopic-choledochoscopic polypectomy has been reported to remove polyps and to preserve the gallbladder [5, 9]. However, the long-term outcome of this technique needs to be explored.…”

Gallbladder Adenoumatous Polyps prevelance in Cholcystectomy in Saudi Arabia-cross sectional study

“…Wang et al, suggested doing polypectomy only, without cholecystectomy by using endolap (endoscopic laparoscopic technique) through experimental laboratory, which was successful and safe [50].…”