title: Transumbilical single-incision laparoscopic cholecystojejunostomy using conventional instruments: the first two cases.
abstract: OBJECTIVE
  Optimization of quality of life is an important goal in the management of patients with unresectable peri-ampullary cancer. Herein, we share our two cases to demonstrate the feasibility of scarless transumbilical single-incision laparoscopic cholecystojejunostomy using conventional instruments in the management of unresectable peri-ampullary cancer.
  
  
  METHODS
  Two 58-year-old patients (one male) underwent transumbilical single-incision laparoscopic cholecystojejunostomies: The male and female patients were diagnosed with duodenal papillary carcinoma and pancreatic cancer, respectively. The hepatocystic junction was confirmed patent preoperatively in both patients. 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 cholecystojejunostomy.
  
  
  RESULTS
  The procedures were completed uneventfully in 190 and 155 min, respectively, with no complications, and the blood loss was estimated at 80 and 20 ml, respectively. Postoperative pain scores on postoperative day 1 were 4/10 and 3/10. The patients were discharged from the hospital on postoperative days 3 and 5 with resolving jaundice.
  
  
  CONCLUSIONS
  Transumbilical single-incision laparoscopic cholecystojejunostomy appears to be a technically feasible alternative to standard laparoscopic procedure and can be performed using conventional laparoscopic instruments.
authors.affiliation: Department of Biliary Surgery, Shengjing Hospital, China Medical University, #36 Sanhao Street, Shenyang, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Tian
authors.forename: Shuo-Dong
authors.initials: SD
authors.lastname: Wu
authors.forename: Yong-Sheng
authors.initials: YS
authors.lastname: Chen
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Chen
mesh_terms: D001706:Biopsy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002767:Cholecystostomy / Q000295:instrumentation*; D003937:Diagnosis, Differential; D004379:Duodenal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007582:Jejunostomy / Q000295:instrumentation*; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*