[Transcystique decompression after laparoscopic exploration of common bile duct: an efficient and safe method]

Laparoscopic exploration is one of the modalities of treatment of choledocolithiasis. Modalities of biliary decompression after laparoscopic common bile duct exploration are controversial to assess the benefits, the efficacity and harms of trancystic biliary drainage following laparoscopic common bile duct stone exploration. We report retrospectively twenty patients which were operated in our department by laparoscopy and have done a transcystic biliary drainage. The mean age was 52 years. They were twenty patients [13 women and 7 men]. The median operating time was 165 minutes. Post operative course was uneventful in 17 cases. Biliary complications were present in three patients [2 biliary fistulas and one biliary peritonitis. Residual stones were found in two cases. One of the residual stone was treated with endoscopic sphincterotomy. There were no post operative deaths. There were no biliary stricture and no recurrent ductal stones. Despite of our short experience, the transcystic biliary drainage following laparoscopic management for choledocolithiasis seems to be a safe and an efficient method

[Pancreatic pseudocysts complicated by hemorrhage and infection]

The occurrence of bleeding complications secondary to the development of pancreatic pseudocysts is rare but associated with high mortality. To report a case of pancreatic pseudocyst complicated by hemorrhage and infection A 62 years old patient with history of severe acute pancreatitis two months ago consulted for abdominal pain associate with fever and internal bleeding. CT scan showed a heterogeneous PK complicated by hematoma of the ACE and hemoperitoneum. The emergency surgical treatment showed a PK superinfected with erosion of the splenic artery. It was directed by a left splenopancreatectomy Therapeutic management of hemorrhagic complications of pancreatic pseudo cysts is surgery despite the contribution of art‚rio-embolisation

[Laparoscopic repair of a post-traumatic ruptured diaphragm: case report]

We report an observation of traumatic rupture of the diaphragm repaired laparoscopically. A 23-year-old man was admitted to our hospital two days after having undergone a traffic accident. The diagnosis was evoked by chest radiograph, then confirmed by Computed tomography scan, in front of an ascension of the left diaphragmatic cupola and an intra-thoracic digestive clarity. Seen the hemodynamic stability of the patient, a laparoscopic repair was indicated. The intra-abdominal pressure was fixed at 10 mm Hg. Despite the retraction of the diaphragmatic banks and the posterior seat of the breach, the intervention was held without any major incident. The postoperative course was marked by the formation of an encysted left pleural hematoma evacuated by a lung decortication. The evolution was normal thereafter