Predictive factors of morbidity after surgical treatment of hydatid cyst of the liver

Hepatic hydatid cyst is a major health problem in endemic areas. Surgery is still the best choice for treatment of the hydatid cyst of the liver. However, it is still associated with high mortality and morbidity. The aim of the study was to evaluate the predictive factors for specific morbidity after conservative surgical treatment of the hydatid cyst of the liver. A total of 120 patients who underwent conservative surgical treatment between 2001 and 2011 were evaluated retrospectively. Of the 120 patients, 64 were female subjects and 56 male subjects; the median age was 33 years [14-83 years]. The mortality rate was 0%. The overall morbidity rate was 26.6%. The specific morbidity rate was 16.6%. The major specific complications were infection of the residual cavity in 10 cases and an external biliary fistula in eight cases. The predictive factors of morbidity in univariate analysis were bilious cyst content, location of the cyst in the hepatic dome, and size >10 cm. After multivariate analysis, only the size of the cyst was an independent predictive factor of morbidity. The size of the cyst was the significant predictor of morbidity of conservative surgery for liver hydatid cyst

Primary lumbar hernia: analysis of three cases

Lumbar hernia is relatively rare; it is due to a defect of the posterior abdominal wall. To report three new cases of lumbar hernia and insist of the modalities of treatment. There are 2 women and one man. Mean age was 78 years. The mean symptom was lumbar mass. All patients had open surgery [by lumbar incision]. The post operative course was uneventful. Primary lumbar hernias are rare. Earlier diagnosis of non complicated hernia should be of primary importance to avoid some serious complication. The only curative treatment is surgery and must be done as soon as the diagnosis was made

[Results of laparoscopic treatment of morbid obesity: about 27 cases]

Prevalence of obesity is increasing steadily. It exposes the patient to numerous complications and represents a serious public health issue. Various treatments were tried. Surgery is actually a credible alternative. Many techniques can be made by laparoscopic approach. To evaluate early and late results of laparoscopic treatment of morbid obesity by two techniques: gastric banding adjustable and gastric by-pass. From May 2001 to July 2007, 27 patients were laparoscopically operated on for severe obesity in our department. Twenty four patients were treated with a gastric banding and 3 patients with gastric bypass. The primary endpoint was: excessive weight loss [EWL], BMI variations and patients' satisfaction. The secondary endpoints were mortality, morbidity and conversion. The mean age was 36 years. There were 4 males and 23 females. The mean preoperative weight was 122, 4kg [range: 87-152] and the mean body mass index [BMI] was 42.5 kg/m2 [range 36,5 -52 kg/m2]. The mean hospital stay was 4.76 days [range: 3-8]. There were no postoperative deaths. Early complication was present in 3 patients. Late complications were present in one patient. No conversion to laparotomy was necessary. BMI decreased from 42.9 to 31 kg/m2 and EWL reached 43%.The results of our experience are encouraging with an acceptable complication rate and no death. Laparoscopic treatment can be done with good results