Is surgery safe in gallstone-related acute diseases in elderly patients?

Objective: To determinate the safety of the surgical treatment of acute biliary pancreatitis and acute cholecystitis in elderly patients

Study Design: Observational study

Place and Duration of Study: Department of General Surgery, Elazig Training and Research Hospital, Elazig, Turkey, from January 2010 to July 2012

Methodology: Records of 172 patients with acute complications of biliary calculi, aged over 65 years, were included. Patients were assessed for demographic information, hospitalisation diagnosis, leucocyte count, ASA classification, treatment type, conversion rates, length of hospital stay, morbidity and mortality. Statiscal analyses were performed using the SPSS version 20.0

Results: The sample included 128 females [74.4%] and 44 males [25.6%]. Patients' diagnoses included 135 [78.4%] acute cholecystitis and 37 [21.6%] acute pancreatitis. Medical treatment was offered to 113 patients [65.7%]. Open cholecystectomy was directly performed in 17 patients [9.9%]. Two patients [4.8%] were converted to an open cholecystectomy during surgery, while a laparoscopic cholecystectomy was performed sucessfully on 42 patients [24.4%]. Those who underwent surgery were discharged as cured, except for minimal surgical complications

Conclusion: Treatment choice in acute gallstone complications in the elderly depends on the patient's general condition, severity of the disease, and ASA score. Early laparoscopic cholecystectomy is a good option in selected elderly patients with acute cholecystitis and non-severe acute biliary pancreatitis

Littoral-cell angioma of the Spleen

Littoral- cell angioma [LCA] is a rare vascular tumor of the spleen. It was thought to be a benign, incidental lesion. However, many recent reports have described it to be a malignant lesion with congenital and immunologic associations. We report a case of LCA of the spleen, which has been infrequently communicated in the literature. A 41-year-old female patient was admitted to our hospital with a three-week history of weakness, weight loss, anorexia, and intermittent upper abdominal pain which improved slightly with antacid medication.Imaging studies, including computed tomography [CT] and magnetic resonance imaging [MRI], showed multiple lesions in the spleen. Laparoscopic splenectomy was performed