Handling of biliary complications following laparoscopic cholecystectomy in the setting of Tripoli Central Hospital.

Background: Laparoscopic cholecystectomy (LC) has an increased incidence of bile duct injury and bile leak when compared with open cholecystectomy. This study reviews management of these complications in a general hospital setting. Data collected from patients diagnosed and treated in one surgical unit for biliary complications after LC between 1992 and 1996 were analysed.

Pericystectomy for the treatment of hepatic hydatid cysts.

Management of the pericystic membrane is still a major problem in the treatment of hepatic hydatid disease. In a series of 23 patients with 45 cysts, complicated forms constituted 51% of all cysts. Radical removal, mainly by pericystectomy, was achieved in two thirds of cysts and in 50% of cases.

A rare extrahepatic biliary anomaly.

In a case operated on for calculous jaundice the right and left hepatic ducts drained directly into the gallbladder and the cystic duct was the only route by which hepatic bile reached the duodenum. Exploration of the inside of the gallbladder was a crucial step for the discovery of the anomaly. Continuity of bile drainage was secured by the preservation of a portion of the gallbladder which contained hepatic and cystic ducts.

Smooth muscle tumors of the stomach.

Six cases of smooth muscle tumors of the stomach are reported. These comprise one leiomyosarcoma and five leiomyomas, observed over a period of five years. Clinical presentation, diagnosis difficulties and the method of treatment are discussed and the literature is reviewed.

Common bile duct exploration in a Libyan hospital. Utilization of choledochoscopy in an effort to improve results.

Over a three-year period, 849 patients had a cholecystectomy for gallstones, at the Central Hospital, Tripoli, Libya. In 133 patients the common bile duct was explored. Under the particular circumstances in which the operation is performed, choledochoscopy was shown to have important advantages to the patient in both locating common duct stones and in ensuring that none is left behind.

Hepatic hydatid disease in Libya.

A series of 50 patients with hepatic hydatid disease all treated at the Central Hospital, Tripoli, Libya is presented to show the advantage of ultrasonography in pre-operative diagnosis and the advantages of complete resection or omentoplasty compared with removal of the endocyst and drainage.

Delayed presentation of traumatic diaphragmatic rupture of right side with herniation of stomach and colon. A case report.

A case of post-traumatic diaphragmatic rupture with herniation of viscera on the right side is reported. The simple procedure of insertion of a nasogastric tube and subsequent chest X-ray were diagnostic. Methods of diagnosis, treatment and a short review of the literature are presented.