Duodenal injury post laparoscopic cholecystectomy: Incidence, mechanism, management and outcome.

Aim: To study the etiopathogenesis, management and outcome of duodenal injury post laparoscopic cholecystectomy (LC).

Methods: A Medline search was carried out for all articles in English, on duodenal injury post LC, using the search word duodenal injury and LC. The cross references in these articles were further searched, for potential articles on duodenal injury, which when found was studied.

Laparoscopic Repair of Bochdalek Diaphragmatic Hernia in Adults.

Bochdalek hernia (BH) is an uncommon form of diaphragmatic hernia. The rarity of this hernia and its nonspecific presentation leads to delay in the diagnosis, with the potential risk of complications. This review summarizes the relevant aspects of its presentation and management, based on the present evidence in the literature.

Choledochal Cyst in Adults: Etiopathogenesis, Presentation, Management, and Outcome-Case Series and Review.

Background. Choledochal cyst, a rare congenital cystic dilatation of biliary tree, is uncommon in adults. Their presentations differ from children and surgical management has evolved.

Laparoscopic Adrenalectomy for Large Adrenocortical Carcinoma.

Background: Adrenocortical cancer (ACC) is a rare disease that is difficult to treat. Laparoscopic adrenalectomy (LA) is performed, even for large adrenocortical carcinomas. However, the oncological effectiveness of LA remains unclear.

Intraductal Papillary Mucinous Neoplasm of Pancreas.

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are neoplasms that are characterized by ductal dilation, intraductal papillary growth, and thick mucus secretion. This relatively recently defined pathology is evolving in terms of its etiopathogenesis, clinical features, diagnosis, management, and treatment guidelines. A PubMed database search was performed.

Laparoscopic cholecystectomy in cirrhotics.

Background And Objectives: Due to the concern of risk of intra- and postoperative complications and associated morbidity, cirrhosis of the liver is often considered a contraindication for laparoscopic cholecystectomy (LC). This article intends to review the literature and underline the various approaches to dealing with this technically challenging procedure.

Methods: A Medline search of major articles in the English literature on LC in cirrhotic patients over a 16-y period from 1994 to 2011 was reviewed and the findings analyzed.

Pancreatic fistula after pancreatectomy: definitions, risk factors, preventive measures, and management-review.

Resection of pancreas, in particular pancreaticoduodenectomy, is a complex procedure, commonly performed in appropriately selected patients with benign and malignant disease of the pancreas and periampullary region. Despite significant improvements in the safety and efficacy of pancreatic surgery, pancreaticoenteric anastomosis continues to be the "Achilles heel" of pancreaticoduodenectomy, due to its association with a measurable risk of leakage or failure of healing, leading to pancreatic fistula. The morbidity rate after pancreaticoduodenectomy remains high in the range of 30% to 65%, although the mortality has significantly dropped to below 5%.

Pancreaticopleural fistula: revisited.

Pancreaticopleural fistula is a rare complication of acute and chronic pancreatitis. This usually presents with chest symptoms due to pleural effusion, pleural pseudocyst, or mediastinal pseudocyst. Diagnosis requires a high index of clinical suspicion in patients who develop alcohol-induced pancreatitis and present with pleural effusion which is recurrent or persistent.

Management of duodenal perforation post-endoscopic retrograde cholangiopancreatography. When and whom to operate and what factors determine the outcome? A review article.

Context: Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic tool to primarily therapeutic procedure. With this, the complexity of the procedure and risk of complication including duodenal perforation have increased. In this article, the recent literature is reviewed to identify the optimal management and factors influencing the clinical outcome.

"Laparoscopic excision of a large ovarian cyst herniating into the inguinal canal: a rare presentation".

Inguinal hernia repair is one of the most common operation in surgical practice. Despite its common occurrence, hernia often poses a surgical dilemma even for a skilled surgeon. The unexpected hernial content constitutes one of these cases.

Biliary complications postlaparoscopic cholecystectomy: mechanism, preventive measures, and approach to management: a review.

Laparoscopic cholecystectomy has emerged as a gold standard therapeutic option for the management of symptomatic cholelithiasis. However, adaptation of LC is associated with increased risk of complications, particularly bile duct injury ranging from 0.3 to 0.

Large posterior mediastinal retrosternal goiter managed by a transcervical and lateral thoracotomy approach.

Most retrosternal goiters are situated in the anterior mediastinal compartment. Posterior mediastinal goiters are uncommon, comprising 10%-15% of all mediastinal goiters. Although most of the anterior mediastinal goiters can be removed by a transcervical approach, posterior mediastinal goiters may require additional extracervical incisions.

Laparoscopic Splenectomy Using LigaSure.

Background: Laparoscopic splenectomy (LS) has become the standard approach for most splenectomy cases. Bleeding is the main complication and cause for conversion. We present our experience with the LigaSure and discuss its advantage as a vessel sealing system in achieving safe vascular control.

Large duodenal gastrointestinal stromal tumor presenting with acute bleeding managed by a whipple resection. A review of surgical options and the prognostic indicators of outcome.

Context: Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and constitute a relatively small subset of GISTs which presents a unique dilemma having various surgical options. A case of a large ulcerating duodenal GIST arising from the second and third parts of the duodenum and involving the pancreas which was managed by a Whipple resection is presented. The literature is also reviewed to present the current status on surgical options, outcome, prognostic indicators and the role of imatinib mesylate in its management.

Portal vein thrombosis postlaparoscopic splenectomy presenting with infarction of gut: review of risk factors, investigations, postoperative surveillance, and management.

Portal vein thrombosis after laparoscopic splenectomy is a known complication even though it is underappreciated. Presenting symptoms are usually mild and nonspecific. Progression to intestinal infarction and portal hypertension are potentially life threatening complications.

Pancreatic metastasis from colon carcinoma nine years after a hemicolectomy managed by distal pancreatectomy. A review of the literature regarding the role and outcome of pancreatic resection for colorectal metastasis.

Context: Pancreatic metastasis from colorectal malignancy is rare and accounts for less than 2% of all pancreatic metastases. A case of colonic metastasis to the pancreas is reported and the literature is reviewed to assess the role and outcome of pancreatic resection for metastatic tumors from colorectal malignancy.

Case Report: A 58-year-old female underwent an emergency left hemicolectomy for an obstructing descending colon growth.

Neutropenic enterocolitis: A continuing medical and surgical challenge.

Aim: Neutropenic enterocolitis is a life threatening complication occurring most frequently after intensive chemotherapy in acute leukemia and solid tumors. This review aims to explore the pathogenesis of the condition and appraise the option and outcome of conservative and surgical management based on the literature review.

Material And Methods: A Medline search was carried out and most of the relevant papers in English literature from 1973 onwards on neutropenic enterocolitis were reviewed

Results: Twelve reports of single cases, 21 reports of 2 to 4 cases and 15 reports of 5 or more cases were identified.

Crohn's disease of the appendix with enterocutaneous fistula post-appendicectomy: An approach to management.

Context: Isolated involvement of the appendix in Crohn's disease is reported to be 0.2% to 1.8%, and is usually associated with ileocaecal Crohn's disease in 25% of ileal and 50% of caecal disease.

Laparoscopic cholecystectomy in the third trimester of pregnancy: report of 3 cases.

Aim: Symptomatic cholelithiasis and acute appendicitis are the most common surgical conditions requiring nonobstetric abdominal surgery during pregnancy. Cholelithiasis is diagnosed in 0.07% of pregnancy and in about 40% of these patients surgery may be required.

Laparoscopic appendicectomy in all trimesters of pregnancy.

Background: The laparoscopic approach for appendicectomy in pregnancy was not considered the preferred procedure until recently. The aim of this study was to examine our experience with laparoscopic appendicectomy in pregnancy and review the scientific evidence available in the medical literature.

Method: The clinical data of all patients who underwent laparoscopic appendicectomy during pregnancy at our hospital between 1999 and 2007 were collected and retrospectively analyzed.

Splenectomy for haematological disorders: a single center study in 150 patients from Oman.

Background: Haematological disorders, in particular sickle cell disease (SCD) and thalassaemia, are relatively common in Oman. We report our experience of splenectomy for haematological disorders and review the literature on splenectomy role in their management.

Objectives: To review our experience in the management of 150 patients with haematological disorders undergoing splenectomy with emphasis on indications and outcome.

Pancreatic metastasis from renal carcinoma managed by Whipple resection. A case report and literature review of metastatic pattern, surgical management and outcome.

Context: Metastatic cancer to the pancreas is rare and accounts for less than 2% of all pancreatic malignancies, metastasis from renal cell carcinoma being predominant. While symptomatic patients present with obstructive jaundice, abdominal pain, or GI bleeding, the diagnosis is often made in asymptomatic patients during follow-up for renal cell carcinoma. Hence, a high index of clinical suspicion is required in a patient who presents with a pancreatic tumor following a nephrectomy for renal cell carcinoma.

Laparoscopic cholecystectomy in a patient with situs inversus totalis: feasibility and technical difficulties.

Situs inversus is a rare anomaly characterized by transposition of organs to the opposite side of the body. In patients with this anomaly, cholelithiasis is observed with a frequency similar to that in the normal population. Herein, we report on a patient with situs inversus totalis who underwent laparoscopic cholecystectomy for mucocele of the gallbladder.

Appendiceal tumour--retrospective clinicopathological analysis.

Appendiceal tumours are rare and often discovered unexpectedly in an acute situation in which decision-making is difficult. We report the spectrum of appendiuar tumours seen in our institution over a period of more than 10 years, and discuss the clinicopathological behaviour, investigations, surgical procedures and outcomes in these patients. We have also reviewed the literature with regard to appendiceal tumours.