Elective Laparoscopic Cholangiography in Lithiasic Pathology. Intraoperative Selection Criteria.

Introduction: The introduction of laparoscopic techniques has caused the dispute between supporters of routine or elective intraoperative cholangiography to continue, but at present most authors recommend its elective practice on the basis of well-established preoperative and / or intraoperative indications, thus avoiding to carry out a large number of unnecessary procedures, with their inherent disadvantages and risks.

Method: A retrospective study was conducted over 20 years, comprising 100 elective laparoscopic cholangiographies.

Results: The most representative parameter for the indication of intraoperative laparoscopic cholangiography in choledochal lithiasis suspicion has proved to be common bile duct dilation of over 3mm, optionally accompanied by cystic calculi and / or main bile duct dilation over 10mm.

Retropancreatic approach in the treatment of pancreatic suppurations.

The authors present an additional retropancreatic access path used in the treatment of suppurations that are subsequent to severe acute pancreatitis. The approach utilized by them, namely the submesocolic one, involves the performance of the decollement and reclining to the right of Treitz's angle, thus granting full access to the pancreatic compartment situated to the left of the superior mesenteric vascular pedicle. The indication for the use of this retropancreatic approach is determined on CT scan criteria, after receiving the data offered by the oral and intravenous contrast media.