Structured learning and mentoring: shortening the learning curve in laparoscopic common bile duct exploration.

Background: Technological advances have made the laparoscopy procedure popular for simultaneous cholecystectomy and bile duct exploration. We aimed to assess the implementation of a structured mentorship program for training in laparoscopic common bile duct exploration (LCBDE). We explored the effectiveness thereof in facilitating the learning of LCBDE as a single-stage treatment of common bile duct stones (CBD) with gallbladder in situ.

Learning curve for performing laparoscopic common bile duct exploration in biliary surgery 2.0 era.

Background: Recent trials and metanalysis have demonstrated the favorable results of laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) for the treatment of cholecysto-choledocholithiasis. The aim of this study was to evaluate the LC + LCBDE learning curve including transcystic and transductal approaches and its effect on the outcomes.

Methods: We identified all unselected patients who underwent LC + LCBDE by a single surgeon between May 2017 and July 2021.

Multi-institutional expert update on the use of laparoscopic bile duct exploration in the management of choledocholithiasis: Lesson learned from 3950 procedures.

Background: Recently there has been a growing interest in the laparoscopic management of common bile duct stones with gallbladder in situ (LBDE), which is favoring the expansion of this technique. Our study identified the standardization factors of LBDE and its implementation in the single-stage management of choledocholithiasis.

Methods: A retrospective multi-institutional study among 17 centers with proven experience in LBDE was performed.

Porcine Aorto-Renal Artery (PARA) model for laparoscopic transcystic common bile duct exploration: the evolution of a training model to meet new clinical needs.

Background: The transcystic approach to laparoscopic common bile duct exploration has gained popularity for the single-stage management of choledocholithiasis with concomitant gallstones. Our team previously described the use of a porcine aorta segment to simulate the common bile duct during laparoscopic skill training.

Methods: With the advent of the transcystic approach as a contender for the first-line technique of accessing the common bile duct, we present an evolution of the laparoscopic training model using a Porcine Aorta-Renal Artery (PARA) specimen to simulate the structural integrity, dimensions and spatial distribution of both the human cystic and common bile ducts.

The ABCdE score for PREdicting Lithotripsy Assistance during transcystic Bile duct Exploration by Laparoendoscopy (PRE-LABEL).

Background: Common bile duct (CBD) stones are reported in ~ 15% of patients who undergo laparoscopic cholecystectomy for symptomatic gallstones. Prior to lithotripsy techniques, transcystic laparoscopic common bile duct exploration (LCBDE) was limited to smaller CBD stones. The addition of lithotripsy to LCBDE increases cost, operative time and staffing requirements.

Impact of resection margins for colorectal liver metastases in laparoscopic and open liver resection: a propensity score analysis.

Background: There is no clear consensus over the optimal width of resection margin for colorectal liver metastases (CRLM), with evolving definitions alongside the advances on the management of the disease. In addition, data on the impact of resection margin after laparoscopic liver resection are still scarce.

Methods: Prospectively maintained databases of patients undergoing open or laparoscopic CRLM resection in 7 European tertiary hepatobiliary referral centres were reviewed.

Laparoscopic parenchymal sparing resections in segment 8: techniques for a demanding and infrequent procedure.

Background: Laparoscopic liver resections for lesions in the postero-superior segments are technically demanding due their deep location and relation with the vena cava. However, previous reports have demonstrated the feasibility and safety of these resections in centres with advanced experience in laparoscopic liver surgery. In this case series, we present our results and experience of laparoscopic parenchymal sparing liver resections of lesions in segment 8.

Laparoscopic Versus Open Liver Resection for Colorectal Metastases in Elderly and Octogenarian Patients: A Multicenter Propensity Score Based Analysis of Short- and Long-term Outcomes.

Objective: This study aims to compare the perioperative and oncological outcomes of laparoscopic and open liver resection for colorectal liver metastases in the elderly.

Background: Laparoscopic liver resection has been associated with less morbidity and similar oncological outcomes to open liver resection for colorectal liver metastases (CRLMs). It has been reported that these benefits continue to be observed in elderly patients.

Oxidative stress influence on renal dysfunction in patients with obstructive jaundice: A case and control prospective study.

Background: Obstructive Jaundice (OJ) is associated with a significant risk of developing acute renal failure (ARF). The involvement of oxidative stress in the development of cholestasis has been demonstrated in different experimental models. However, its role in the morbidity of human cholestasis is far to be elucidated.

Real anal leiomyoma: a case report.

Leiomyoma of the rectum and anal canal is an unusual benign mesenchymal neoplasm that originates from smooth muscle cells. We describe the clinical presentation, MRI findings, and surgical treatment of a rare case of perianal leiomyoma confirmed by immunohistochemistry. We also report a review of the world's literature on the subject.

Uterine leiomyosarcoma metastasis to the pancreas: report of a case and review of the literature.

Introduction: Uterine leiomyosarcoma is an aggressive malignant tumor that often leads to metastatic dissemination, generally in the lungs, liver, brain, and bones. Despite the fact that pancreatic neoplasms spread easily, the pancreas is not a usual target organ from other neoplasms.

Case Report: We present a rare case of metastasis to the pancreas from uterine leiomyosarcoma treated with segmental resection with no recurrence at this stage.

[Advantages of laparoscopic stented choledochorrhaphy. Six years experience].

Background: Laparoscopic common bile duct exploration (LCBDE) is nowadays a valid option in the management of common bile duct stones. T tube and primary closure have been used to close the choledochotomy, but these methods are not free of complications. We present our experience with the stented choledochorrhaphy.

Rectothecal fistula secondary to an anterior sacral meningocele.

A rectothecal fistula secondary to anterior sacral meningocele is an extremely rare disease. To the authors' knowledge, only 2 cases have been reported in the English-language literature. It can cause symptoms by compressing adjacent structures, causing urinary difficulties and constipation.

Conservative management of perforated duodenal diverticulum: a case report and review of the literature.

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach.

[Spontaneous intramural small bowel hemorrhage: an event on the increase].

Spontaneous intramural intestinal hemorrhage is highly infrequent. The most common cause is overdose of oral anticoagulants. Clinical presentation usually consists of abdominal pain and intestinal obstruction.