Tele-colleaguography - Adjunct to Intraoperative Time Out for Safe Laparoscopic Cholecystectomy.

Laparoscopic cholecystectomy is a common surgical procedure, and strategies for preventing biliovascular injury include intraoperative time-out and intraoperative cholangiography. However, the feasibility of intraoperative cholangiography is limited in certain regions due to cost and training constraints. This article introduces the concept of "Tele-colleaguography" as an adjunct to intraoperative time-out during laparoscopic cholecystectomy, particularly in low-resource settings.

A case report on multidisciplinary approach towards management of gastrojejunocolic fistula secondary to adenocarcinoma of the colon.

Introduction: Gastrojejunocolic fistula is an abnormal communication between a portion of the stomach, jejunum and the transverse colon. Gastrojejunocolic (GJC) fistula is an outcome resulting from the surgical procedures of gastrectomy and gastrojejunostomy used to address recurrent peptic ulcer disease and secondary to malignancy. Patients present with the typical symptoms of diarrhea, belching with fecal odor or fecal vomiting and weight loss.

Ghost complications in biliary surgery: A case series on pneumobilia.

Introduction: Laparoscopic cholecystectomy is a commonly performed surgical procedure and there are instances where complications may occur intraoperatively which can go undiagnosed or unreported and the patient can present at a later time with the manifestations of those complications. This study presents a case series comprising three instances of "ghost complications" following laparoscopic cholecystectomy, emphasizing the utmost significance of careful follow-up care and efficient communication to promptly recognize and manage any complications arising after the surgery.

Case Presentation: Three cases of ghost complications post-biliary surgery are presented.

Liver pucker sign: predictor of difficult laparoscopic cholecystectomy: a case series.

Introduction: Pucker sign is the depression of the liver in the region of the gallbladder due to a high degree of chronic contractive inflammation of the gallbladder. It usually develops in patients who have a delayed cholecystectomy after acute cholecystitis due to a high degree of chronic contractive inflammation of the gallbladder and contraction of the cystic plate. It is an essential finding either preoperatively or intraoperatively as it can act as a stopping rule during cholecystectomy (act as a guide that cholecystectomy will be difficult).

Central Pancreatectomy for Bilobed Solid Pseudopapillary Tumor of Pancreas.

Solid-pseudopapillary tumor of pancreas is a rare pancreatic tumor that occurs predominantly in a young female with only a small minority concerning children. These tumors have low malignant potential, found incidentally which are usually single lobed. Surgical resection remains the mainstay of treatment.

Feasibility of Telementoring as an Intraoperative Time-out Tool during Laparoscopic Cholecystectomy for Prevention of Biliovascular Injuries.

Laparoscopic cholecystectomy is commonly performed procedure for gallbladder diseases. Biliovascular injuries are well known complications and various standard and safe strategies have been developed for safe cholecystectomy. Intraoperative time out is one of the strategies where two or more surgeons stop during surgery before dividing any structure in Calot's triangle.

Outcomes of Laparoscopic Cholecystectomy in a Tertiary Hospital in Nepal.

Background Laparoscopic Cholecystectomy (LC) is the gold-standard surgery for symptomatic cholelithiasis with low mortality and morbidity. Objective The main objective of this study is to study the outcomes of laparoscopic cholecystectomy in Dhulikhel Hospital over the period of seven years. Method The records of all the patients who underwent laparoscopic cholecystectomy in Dhulikhel Hospital from January 1, 2015, to December 31, 2021 were reviewed.

Diagnostic Dilemma in Groove Pancreatitis: A Case Report.

Groove pancreatitis is uncommon form of chronic pancreatitis common in patients with history of smoking and alcohol abuse. High index of suspicion is required as it may masquerade pancreatic ductal adenocarcinoma and both of these conditions are difficult to differentiate preoperatively. Pancreaticoduodenectomy has good outcome in patient with Groove pancreatitis.

Appropriateness of Indications of Upper Gastrointestinal Endoscopy and its Association With Positive Finding.

Introduction: Upper Gastrointestinal Endoscopy is a frequently advised investigation for upper abdominal symptoms. Studies have questioned the appropriateness of indications for upper gastrointestinal endoscopy and have shown that inappropriate indications range from 5% to 49%. The unnecessary upper gastrointestinal endoscopy expose patients to the risk.

Prospective Validation of a Decision Tree Model for Prediction of Severity in Acute Pancreatitis.

Background: Early identification of severe acute pancreatitis is important for early stratification, goal directed fluid therapy, rationalizing level of care to improve outcome. Various clinical, laboratory and imaging scoring system has been used to identify severe acute pancreatitis with variable results. Recently a decision tree model was proposed using serum creatinine, serum lactate dehydrogenase and oxygenation index to predict severe acute pancreatitis.

Pre-operative Prediction of Difficult Laparoscopic Cholecystectomy.

Introduction: Laparoscopic cholecystectomy is one of the most common operation performed. Though LC have become safer and easier at times it can be difficult. Difficult cases can result in prolonged operative time, bleeding, bile spillage, conversion to open technique and bile duct injury resulting in unplanned prolonged hospital stay, increase in estimated cost to the patients and for the surgeon it leads to increased stress during operation and time pressure to complete the operative list.