Bile leaks after cholecystectomy: the significance of patient selection.

Objective: A retrospective analysis of laparoscopic and open cholecystectomies, with introduction of selection criteria and estimation of postoperative bile leaks.

Method: All patients who underwent cholecystectomy in a tertiary surgical unit from January 2007 to June 2008 formed 2 categories, laparoscopic and open. The choice of operation was based on patient's present status and past medical history, whereas the decision to convert came from intraoperative findings.

Acute cholecystitis: when is the best time for laparoscopic cholecystectomy?

Laparoscopic cholecystectomy is no more an elective procedure. The question is when to perform laparoscopic cholecystectomy in the face of acute cholecystitis. The last decade (1995-2004) 297 patients had a laparoscopic cholecystectomy for acute cholecystitis.

The management of acute gastric volvulus.

Acute gastric volvulus occurs when the stomach or a part of it rotates more than 180 degrees which leads to obstruction (closed loop syndrome), that finally concludes to incarceration and ischemia of the organ. It can be observed as a result of diaphragmatic hernia, a gap of the diaphragm, pancreatic or gastric cancers, traumatic injuries and fixation anomalies. Parï first described acute gastric volvulus in 1579, in a patient with diaphragmatic injury after trauma.