Clinical and economic comparative analysis of laparotomy versus laparoscopy in the first gastric bypass surgeries in a bariatric and metabolic surgery service in a city in southern Brazil.

Introduction: this paper aims to evaluate the main direct and indirect costs of the first laparotomies and laparoscopies in bariatric surgeries with a clinical-economical retrospective and cross-sectional analysis from 2017 to 2020 at a hospital with specialties besides the basic ones in southern Brazil.

Methods: the study sample included 26 participants. The first 13 laparotomies, and the first 13 laparoscopies performed at the bariatric surgery service of the institution were evaluated.

Laparoscopic distal pancreatectomy for insulinoma with preservation of the spleen.

We report on a successful laparoscopic distal pancreatectomy due to insulinoma, preserving the spleen and the splenic vessels in a 29-year-old male patient who presented with repeated syncope due to hypoglycemia. The ultrasound exam did not show the pancreatic lesion; it was only the angiotomography of the pancreas that revealed a 3-cm mass located at the transition from the body to the tail of the pancreas. The laparoscopic distal pancreatectomy was performed using a harmonic scalpel (Ethicon EndoSurgery/UltraCision), without mechanical suturing.

Intermittent total pedicular clamping in hepatic resections in non-cirrhotic patients.

Background/aims: Evaluation of intermittent total pedicular clamping in hepatic resections in non-cirrhotic patients.

Methodology: A prospective study was made of 72 patients submitted to hepatic resections using intermittent total pedicular clamping. Patients were placed in 5 groups for analysis according to the duration of liver ischemia (each 20 minutes).