Laparoscopic exploration of the common bile duct with a rigid scope in patients with problematic choledocholithiasis.

Background: The development of laparoscopic cholecystectomy as a minimally invasive approach to eliminate gallstones, in conjunction with increasingly sophisticated techniques for removal of common bile duct (CBD) stones by endoscopic sphincterotomy, has revolutionized the treatment of choledocholithiasis. We describe a new technical approach to laparoscopic exploration of the CBD after unsuccessful endoscopic stone extraction.

Methods: Eleven patients were subjected to laparoscopic exploration of the CBD with choledochotomy using a rigid scope (24-Fr nephroscope) during the last 2 years.

Central form of multiple symmetric lipomatosis: a case report.

Multiple symmetric lipomatosis (also known as Madelung's disease, Launois-Bensaude syndrome or benign symmetric lipomatosis) is a rare disease, the etiology of which is unknown. Multiple, symmetric, non-encapsulated lipomatous masses on the face, neck, upper arms, and upper trunk are typical in most cases. Five out of the 200 cases reported in the literature were the distal form of the disease; the rest were proximal.

Maternal and fetal near-term sheep cytokine responses to carbon dioxide pneumoperitoneum.

It is known that carbon dioxide (CO2) pneumoperitoneum induces fetal acidosis in pregnant ewes. Our aim was to determine changes of the levels of maternal and fetal cytokines interleukin-6, interleukin-8, and tumor necrosis factor alpha after CO2 pneumoperitoneum in pregnant ewes. Eight ewes with singleton pregnancies of 120 to 140 days gestation were anesthetized and intubated.

Migration of the connecting tube into small bowel after adjustable gastric banding.

Migration of intraabdominal catheters into the bowel is a well-known phenomenon of uncertain cause. Intragastric migration of adjustable gastric banding is not an uncommon complication, with a reported prevalence of 1-11% in most series. Migration of the connecting tube into the small bowel lumen or colonic lumen is very rare.

Laparoendoscopic "rendezvous" versus laparoscopic antegrade sphincterotomy for choledocholithiasis.

Background: The ideal management of common bile duct stones in the era of laparoscopic cholecystectomy is controversial. With rapid advances in technology and more experience in laparoscopic skills, many surgeons are now routinely performing single-stage procedures and questioning the wisdom of preoperative endoscopic retrograde cholangiopancreotography, with or without sphincterotomy. The purpose of this study was to compare the success rate, duration of operating time, clinical results, and duration of hospital stay of a laparoendoscopic "rendezvous" technique versus antegrade sphincterotomy in patients with cholecystitis-choledocholithiasis.

Routine interval appendectomy is unnecessary after conservative treatment of appendiceal mass.

Objective: The traditional management of appendiceal mass is initial conservative treatment followed by interval appendicectomy. Recently interval appendicectomy has been questioned by a growing amount of evidence. The purpose of this study was to clarify the role of interval appendicectomy after successful initial conservative treatment.