Background:
Natural orifice transluminal endoscopic surgery (NOTES) and other miniinvasive techniques are under the experimental investigation. Cholecystectomy is usually the subject of evaluation but studies using healthy animals are lacking for the clinical relevance.
The aim of the experimental study was to create and evaluate surgical model of gallstone cholecystitis in large animal.

Material and Methods:
Laparoscopy was performed in 11 pigs weighing 40,3 ± 10,0 kg. Bile from the bladder was aspirated and 4 gallstones obtained by human cholecystectomy were inserted via cholecystotomy. Laparoscopic (3-ports) cholecystectomy was performed after 1 month. This group was compared to 11 cholecystectomied pigs without lithiasis.

Result:
Model procedure time was 42 (35-75) minutes. White blood cells (WBC) count, CRP and IL-6 increased during 3days after surgery and decrased to normal after 7 days. Gallstone cholecystitis was confirmed by ultrasound and histology 4 weeks after intervention. Laparoscopic cholecystectomy in gallstone model took longer– 63 (42-91) minutes vs. 46 (31-62) minutes (p=0,018). The perioperative gallstone perforation was less frequent in healthy pigs 1/10 vs. 8/11 (RR: 7,27; CI95%: 1,09-48,3; p=0,04) as well as postoperative complications rate 0/10 vs. 2/11 (RR: 4,58; Cl95%: 0,25-85,3; p=0,31).

Conclusion:
Simple and reproducible surgical model of gallstone cholecystitis was created as a reliable tool for more accurate evaluation of NOTES. No elevation of inflammatory markers was observed 4 weeks after intervention.The laparoscopic cholecystectomy was technically more difficult in cholecystitis model than in healthy animals. Supported by NT12250