Reliability testing of a modified MISTELS score using a low-cost trainer box.

Background: Training programs such as the fundamentals of laparoscopic surgery (FLS) that are based on simulation are being currently used in several western countries. FLS allows skill acquisition and evaluation of competency in laparoscopic surgery. On the practical side, evaluation is determined by the MISTELS metrics (MISTELS is the acronym for the McGill inanimate system for training and evaluation of laparoscopic skills).

Gastric leiomyosarcoma and diagnostic pitfalls: a case report.

Background: Since the advent of immunohistochemistry for the diagnosis of stromal tumours, the incidence of leiomyosarcomas has significantly decreased. Nowadays, gastric leiomyosarcoma is an exceptionally rare tumour. We report the second case in the English literature of gastric leiomyosarcoma revealed with massive bleeding and hemodynamic instability and diagnostic pitfalls that we encountered.

[First experience with outpatient laparoscopic cholecystectomy in Tunisia].

Introduction: Laparoscopic cholecystectomy is the gold standard treatment for symptomatic gallstones. There is some debate as to whether it should be performed in outpatient surgery or in one-day surgery to improve patient safety. This study aimed to evaluate the impact of laparoscopic cholecystectomy performed in outpatient surgery versus one-day surgery on standards such as mortality, serious adverse events and quality of life.

Ascending Cholangitis secondary to migrated embolization coil of gastroduodenal artery pseudo-aneurysm a case report.

Background: Gastroduodenalartery (GDA) pseudo-aneurysms are very rare. Their clinical importance lies in the eventuality of rupture, causing bleeding and ultimately exsanguination.

Case Presentation: We report the case of a man, with prior history of biliary surgery, presenting with haemobilia secondary to a rupture of GDA pseudo-aneurysm eroding the main bile duct.

Detection of a new JCV strain of genotype A in a subpopulation of colorectal adenocarcinomas in Tunisia.

The etiology of colorectal cancer (CRC) remains elusive in spite of major advances in knowledge of this disease and related risk factors. Several studies report the detection of human polyomavirus JC (JCV) in colorectal tumors and some suggest its association with CRC. Since many known human virus associations with cancer are linked to factors such as ethnic and geographical origin, it is interesting to search for the postulated association of JCV with CRC in different populations and regions.

[Spigelian hernias].

Spigelian hernias represent 1-2% of all abdominal wall hernias. The pathogenesis often involves a dehiscence of the transverse and internal oblique muscle aponeurosis. The diagnosis is made by physical examination; but sometimes it is complicated by obesity.

Primary hydatid cyst of the gallbladder: an unusual localization diagnosed by magnetic resonance imaging (MRI).

Hydatid disease is endemic in Tunisia and has been considered as one of the most common surgical pathology. Several localizations have been described, but hydatidosis of the liver is the most frequent clinical entity. Primary hydatid cyst of the gallbladder is very rare.

Giant gastric lipoma mimicking well-differentiated liposarcoma.

Authors report the case of a 51-year-old man, presenting with epigastralgia of recent onset. Physical exam was unremarkable. Endoscopy revealed a large, ulcerated, submucosal, antral tumor.

Giant gastric lipoma mimicking well-differentiated liposarcoma.

Gastric lipoma is a rare tumor, accounting for only 5% of gastrointestinal tract lipomas and less than 1% of all gastric tumors. Histological diagnosis is usually easy. However, the tumor may sometimes undergo significant inflammatory changes leading to a difficult differential diagnosis with well-differentiated liposarcoma.

[Feasibility of laparoscopic treatment of duodenal ulcers: results of 160 cases].

Aim: The objective of this study is to evaluate the feasibility, efficacy and safety of laparoscopic repair for perforated duodenal ulcer.

Methods: One hundred and sixty patients were treated by coelioscopic procedure for a perforated duodenal ulcer. The procedure consists on a suture of perforated ulcer associated with a peritoneal lavage.

[Common bile duct distomatosis managed by coelioscopic aproach. One case report].

Biliary distomatosis is caused by a parasitis of trematode family: the fascialo hepatica. It is a rare affection in Tunisia. The diagnostic is often done in the status phase.

[Filiation hamartoma polyposis dysplasia and small bowel adenocarcinoma].

Peutz-Jeghers syndrome is a hereditary affection with dominant autosomal transmission. The risk of cancerisation is largely higher than that in the general population. Dysplasia is rare.