The Short-Term Renal Effects of Bariatric Surgery: A Comparative Study Between Sleeve Gastrectomy and One Anastomosis Gastric Bypass Operations Among Egyptian Patients With Severe Obesity.

Purpose: Obesity is a major health problem with many renal sequelae. Bariatric surgery (BS) has become the treatment of choice for severe obesity. This study was conducted to assess the short-term renal effects of BS and to compare such effects between two distinct forms of BS.

Renal changes and estimation of glomerular filtration rate using different equations in morbidly obese Egyptian patients.

Background And Aims: Obesity is a worldwide pandemic with multiple consequences including kidney affection. This study aimed to assess the effects of obesity on renal functions and to detect the most reliable formula of estimated glomerular filtration rate (eGFR) in morbidly obese patients.

Methods: A cross-sectional, observational study was conducted on 82 morbidly obese patients.

Post-endoscopic retrograde cholangiopancreatography pancreatitis: Risk factors and predictors of severity.

Aim: To detect risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and investigate the predictors of its severity.

Methods: This is a prospective cohort study of all patients who underwent ERCP. Pre-ERCP data, intraoperative data, and post-ERCP data were collected.

Management and Outcome of Borderline Common Bile Duct with Stones: A Prospective Randomized Study.

Introduction: Management of common bile duct stones (CBDS) in patients with borderline CBD presents a surgical challenge. The aim of this study was to compare conservative treatment with endoscopic stone extraction for the treatment of borderline CBD with stones.

Patients And Methods: This prospective randomized controlled trial includes patients with CBDS in borderline CBD (CBD <10 mm) associated with gallbladder stones who were treated with conservative treatment or endoscopic stone extraction followed by laparoscopic cholecystectomy (LC) and intraoperative cholangiogram (IOC).

Laparoscopic Bile Duct Clearance Without Choledochoscopy.

Background: Laparoscopic common bile duct exploration (LCBDE) has been proven to be a safe, efficient, and cost-effective option for the management of common bile duct (CBD) stones. There are two guiding methods during LCBDE: fluoroscopic or choledochoscopic. Most surgeons prefer the use of flexible choledochoscopy at LCBDE, but it is a fragile, delicate, and expensive instrument.

The effect of residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy: a prospective randomized trial.

Background: Laparoscopic sleeve gastrectomy (LSG) is gaining popularity worldwide as a definitive bariatric procedure. However, there are still some controversial issues associated with the technique, one of which is the size of the residual antrum.

Objectives: The aim of this prospective randomized trial is to study the effect of the size of the residual gastric antrum on the outcome of LSG.

Intraoperative endoscopic retrograde cholangio-pancreatography: a useful tool in the hands of the hepatobiliary surgeon.

Aim: To evaluate the efficacy of intraoperative endoscopic retrograde cholangio-pancreatography (ERCP) combined with laparoscopic cholecystectomy (LC) for patients with gall bladder stones (GS) and common bile duct stones (CBDS).

Methods: Patients treated for GS with CBDS were included. LC and intraoperative transcystic cholangiogram (TCC) were performed in most of the cases.

Single-session minimally invasive management of common bile duct stones.

Up to 18% of patients submitted to cholecystectomy had concomitant common bile duct stones. To avoid serious complications, these stones should be removed. There is no consensus about the ideal management strategy for such patients.

Laparoscopic gastric plication: technical report.

Background: Laparoscopic gastric plication is an emerging restrictive bariatric procedure but still lacks standardization of the technique. The aim of this study was to apply a standardized, modified 3-port approach to laparoscopic gastric plication to improve outcomes.

Methods: The modified laparoscopic gastric plication technique was applied for 63 morbidly obese patients between March 2010 and January 2013.

Pancreatic anastomotic leakage after pancreaticoduodenectomy. Risk factors, clinical predictors, and management (single center experience).

Background: Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) remains a challenge even at high-volume centers.

Methods: This study was designed to analyze perioperative risk factors for POPF after PD and evaluate the factors that predict the extent and severity of leak. Demographic data, preoperative, intraoperative, and postoperative variables were collected.

Pancreatic cystic neoplasms: predictors of malignant behavior and management.

Background/aim: Pancreatic cystic neoplasms are being increasingly identified with the widespread use of advanced imaging techniques. In the absence of a good radiologic or pathologic test to preoperatively determine the dianosis, clinical characteristics might be helpful. The objectives of this analysis were to define the incidence and predictors of malignancy in pancreatic cysts.

Laparoscopic exploration versus intraoperative endoscopic sphincterotomy for common bile duct stones: a prospective randomized trial.

Background/aims: Laparoscopic cholecystectomy (LC) combined with intraoperative endoscopic sphincterotomy (IOES) was compared to LC with laparoscopic common bile duct exploration (LCBDE) to define the best single-session minimally invasive treatment for cholecystocholedocholithiasis.

Methods: Between June 2009 and December 2010, patients with gallstones and common bile duct (CBD) stones diagnosed by preoperative ultrasonography and magnetic resonance cholangiopancreatography were randomized to LC-LCBDE or LC-IOES. The primary end point was complete clearance of CBD of stones.

Single-incision laparoscopic cholecystectomy (SILC) using harmonic scalpel.

Background: Single-incision laparoscopic cholecystectomy (SILC) is emerging as a potentially less invasive alternative to standard laparoscopic cholecystectomy (LC). However, this procedure is technically more complex and time consuming. We present our initial experience with SILC using harmonic ACE (HS-SILC) in an attempt to simplify the procedure.

Laparoendoscopic management of concomitant gallbladder stones and common bile duct stones: what is the best technique?

Background And Study Aims: The intraoperative use of endoscopic retrograde cholangiopancreatography (ERCP) during laparoscopic cholecystectomy (LC) is a safe, single-stage option for the management of concomitant gallstones (GS) and common bile duct stones (CBDS). This study aims to compare between 2 techniques of combined laparoendoscopic management, which are laparoendoscopic Rendez-vous (LC/LERV) technique and standard ERCP after the completion of LC intraoperative endoscopic sphincterotomy (IOES).

Patients And Methods: Patients with GS and suspected CBDS were included.

Preoperative versus intraoperative endoscopic sphincterotomy for management of common bile duct stones.

Background: ERCP remains the prevailing method of treating CBDS; however, its ideal timing in respect to laparoscopic cholecystectomy (LC) is not defined. LC combined with intraoperative endoscopic sphincterotomy (IOES) was compared with preoperative endoscopic sphincterotomy (PES) followed by LC for management of preoperatively known cholecystocholedocholithiasis.

Methods: Between June 2006 and September 2009, 198 patients diagnosed preoperatively by clinical assessment, liver chemistry, ultrasonography, and magnetic resonance cholangiopancreatography (MRCP) to have combined choledochocystolithiasis were eligible.

Is the use of T-tube necessary after laparoscopic choledochotomy?

Background: Traditionally, the common bile duct (CBD) is closed with T-tube drainage after choledochotomy and removal of CBD stones. However, the insertion of a T-tube is not without complication.

Aim Of Work: This randomized study was designed to compare the use of T-tube and primary closure of choledochotomy after laparoscopic choledochotomy to determine whether primary closure can be as safe as closure with T-tube drainage.

Self-expanding metal stents in palliation of malignant dysphagia: outcome of 124 Egyptian patients.

Most cases of esophageal carcinoma are inoperable at presentation. Currently, the best method for palliation of malignant dysphagia, with or without esophago-respiratory fistula, is an insertion of esophageal self-expanding metal stents (SEMS) across the malignant esophageal stricture. Herein we present our experience in the use of SEMS in palliation of patients with malignant dysphagia and/or ERF.