ABSTRACT
A 34-year-old female with a history of advanced pulmonary sarcoidosis and right-sided heart failure presented with chronic, postprandial right upper quadrant pain, and weight loss. Endoscopic biliary drainage was deemed to be the most appropriate therapeutic option for her chronic cholecystitis. Endoscopic retrograde cholangiopancreatography utilizing the SpyGlass cholangioscopy system allowed us to access the cystic duct through which the gallbladder was ultimately decompressed, via biliary stent placement and gallstone irrigation. This is the first report of SpyScope assisted placement of fully covered self-expandable metal biliary stents into the cystic duct enabling definitive treatment of symptomatic chronic cholecystitis and cholelithiasis without cholecystectomy.
Subject(s)
Adult , Female , Humans , Cholangiopancreatography, Endoscopic Retrograde , Cholecystectomy , Cholecystitis , Cholelithiasis , Cystic Duct , Drainage , Gallbladder , Gallstones , Heart Failure , Sarcoidosis, Pulmonary , Stents , Weight LossABSTRACT
A prospective randomized clinical trial of 200 patients was conducted to find the value of suturing subcutaneous fat in abdominal surgery using cholecystectomy as a model. There was no significant difference in complications with or without suturing subcutaneous fat. Suturing subcutaneous fat in upper abdominal surgery may be time consuming and unnecessary
Subject(s)
Suture TechniquesABSTRACT
A complication of ventriculo-peritoneal shunt is reported in a 14 months old boy with hydrocephalus, who presented with an enlarging right side of the scrotum of 48 hours duration. The shunt tubing was draining cerebrospinal fluid directly into the right tunica vaginails via a persistent processus vaginalis