Bupivacaine use in the Insuflow device during laparoscopic cholecystectomy: results of a prospective randomized double-blind controlled trial.

Background: Recent evidence [Surg Endosc (2007) 21: 602-606] demonstrates that intraperitoneal bupivacaine administered as an aerosol via a special catheter is safe and significantly decreases postoperative pain in laparoscopic surgery. We currently use the Insuflow device (Lexion Medical) routinely to warm and humidify gas in laparoscopic surgery. The purpose of this study is to determine whether using bupivacaine instead of water in existing technology already in use (Insuflow) will result in decreased postoperative pain, without increasing operative time or cost.

Outcomes after resection of cholangiocellular carcinoma.

Background: Cholangiocellular carcinoma (CCC) is a rare primary liver malignancy that arises from intrahepatic bile duct canaliculi and presents as a liver mass. Our purpose is to report operative morbidity and mortality and to determine long-term survival after resection for CCC.

Methods: Retrospective review of 31 consecutive patients who underwent resection during a 20-year period.

Primary squamous cell carcinoma of the thyroid gland.

A case of primary squamous cell carcinoma of the thyroid is presented. Squamous epithelium is normally not present in the thyroid gland, and this tumor is exceedingly rare. Proper workup is described, including the differentiation from metastatic disease.