Cortisol/DHEA ratio in morbidly obese patients before and after bariatric surgery: Relation to metabolic parameters and cardiovascular performance.

Introduction: Bariatric surgery (BS) is the most effective therapy for morbid obesity. Cortisol and DHEA are steroid hormones with opposing effects, thus using Cortisol/DHEA ratio (C/D) rather than the use of either hormone alone has been found to predict health outcomes more reliably. It was interesting to study C/D as an indicator of favorable metabolic and cardiovascular outcomes after BS.

Is monopolar electrocautery safe and effective for control of the cystic artery during laparoscopic cholecystectomy?

Background: Laparoscopic cholecystectomy is one of the most common surgical procedures. Here we report our experience with the use of monopolar electrocautery to control the cystic artery during laparoscopic cholecystectomy.

Subjects And Methods: Data regarding the site, number, size, and method of control of the cystic artery during laparoscopic cholecystectomy were prospectively collected.

Spinal versus general anesthesia for day-case laparoscopic cholecystectomy: a prospective randomized study.

Background: The aim of this study was to compare the surgical outcome of day-case laparoscopic cholecystectomy (DCLC) performed with the patient under spinal anesthesia with that performed with the patients under general anesthesia in the management of symptomatic uncomplicated gallstone disease.

Patients And Methods: One hundred eighty patients were prospectively randomized to either the spinal anesthesia DCLC group (SA-DCLC group) or the general anesthesia DCLC group (GA-DCLC group). Intraoperative events related to spinal anesthesia, postoperative complications, and pain scores were recorded.

Wandering hemi-spleen: Laparoscopic management of wandering spleen in a case of polysplenia.

Introduction: Several congenital anomalies of the spleen have been reported. The polysplenia is a rare anomaly in which the normal spleen is replaced with two or more smaller spleens. The wandering spleen is another anomaly resulting from the laxity of the splenic ligaments.

Laparoscopic-assisted truncal vagotomy and gastro-jejunostomy: trial of simplification.

Background: Truncal vagotomy and gastro-jejunostomy is an effective procedure for Gastric Outlet Obstruction. The authors' experience with the procedure is presented and an alternative technique for creating the gastro-jejunostomy is described.

Methods: From January 2005 through June 2007, 18 patients with gastric outlet obstruction secondary to a cicatrizing peptic duodenal ulcer underwent laparoscopic truncal vagotomy and an ante-colic laparoscopic-assisted stapled gastro-jejunostomy.

Clipless laparoscopic cholecystectomy by ultrasonic dissection.

Background: Ultrasonically activated devices have been used in gallbladder dissection in the laparoscopic cholecystectomy with encouraging results. The aim of this study was to compare between the safety and efficacy of the harmonic shears and the commonly used clip and cautery technique in achieving safe closure and division of the cystic duct in the laparoscopic cholecystectomy.

Methods: In this prospective study, 120 patients with symptomatic gallstone disease were randomly assigned to either the harmonic scalpel laparoscopic cholecystectomy group (HS group=60 patients) where closure and division of the cystic duct was achieved solely by the harmonic shears or the clip and cautery laparoscopic cholecystectomy group (C&C group=60 patients).

Thoracoscopic splanchnicectomy for pain control in irresectable pancreatic cancer.

Aim: Disabling pain for many patients with irresectable pancreatic cancer is poorly managed and can remain a significant problem until death. The aim of this study was to evaluate the safety and efficacy of thoracoscopic splanchnicectomy for pain control in patients with irresectable pancreatic cancer.

Patients And Methods: Thirteen patients suffering from intractable pain due to irresectable pancreatic cancer underwent 15 attempted thoracoscopic splanchnicectomy procedures.