Management of Major Postcholecystectomy Biliary Injuries: An Analysis of Surgical Results in 62 Patients.

Background: Management of injuries sustained during cholecystectomy requires expertise and involves a patient who is troubled, usually drained of personal resources. There has been an increase in incidence with laparoscopic cholecystectomy. The standard surgical management done for major biliary injuries is Roux-en-Y Hepaticojejunostomy (R-en-Y HJ).

Coverage of chest wall defect in a case of electric burns by pedicled omental flap.

Electrical burns can be devastating and result in dreaded outcomes. Electrical burn is a common problem in our society and needs special attention because of its various modes of presentations, the numbers of organ systems involved, and the mortality associated in spite of the small percent of burns. The authors present a case of electrical burns with a posterolateral chest wall defect associated with blunt abdominal trauma that was successfully managed by debridement and pedicled omental flap over a synthetic prolene mesh.

Portal hypertension: effect of early splenic artery ligation on platelets count during splenectomy.

Background/aim: Hypersplenism due to splenic congestion is observed in portal hypertensive patients. This study was done to know the change in platelets count following early ligation of splenic artery during splenectomy in patients with thrombocytopenia due to portal hypertension with a hypothesis that splenic decongestion results in increased platelets count; thereby platelet transfusion can be avoided.

Materials And Methods: Patients with platelets count <100,000 per mm(3) due to portal hypertension were involved and we followed a protocol of ligating splenic artery first, followed by 30 minutes waiting period for splenic decongestion.

Choledochal cysts : a review of literature.

Choledochal cysts are cystic dilation of extrahepatic duct, intrahepatic duct, or both that may result in significant morbidity and mortality, unless identified early and managed appropriately. The incidence is common in Asian population compared with western counterpart with more than two third of the cases in Asia being reported from Japan. The traditional anatomic classification system is under debate with more focus on etiopathogenesis and other aspects of choledochal cysts.

A prospective randomized, controlled study comparing low pressure versus high pressure pneumoperitoneum during laparoscopic cholecystectomy.

Background: The increase in intra-abdominal pressure by insufflation of carbon dioxide during laparoscopy brings certain changes in function of organ systems and also leads to postoperative pain. Degree of intra-abdominal pressure is directly related with such change. Laparoscopic cholecystectomy can be performed at low pressure pneumoperitoneum.