Minilaprotomy cholecystectomy with mini clip applicator a useful alternative to laparoscopic cholcystectomy

To analyze outcome of after LC [Laparoscopic Cholecystectomy] and MC [Minilaparotomy Cholecystectomy] for symptomatic Gall Stones. Randomised prospective study. Lahore General hospital Lahore from January 2003 to December 2004. Study comprised of two groups [A and B] of 320 people with 160 patient in each group. Group A was offered LC and Group BMC outcome data looked at operative time, rate of conversion to conventional cholecystectomy, operative complication, post of stay, wound infection and patient satisfaction. A total number of 320 patients underwent cholecystectomy with 160 in each LC and MC group. There were 280 [77%] females and 40[33%] males. Median operating time was 60 and 40 minutes for LC and MC, while conversion to conventional cholecystectomy was 12.5% in LC group and 6% in MC group. There was 3% minor bile duct injury in LC and 0% in LC group. There was 6% of wound infection in LC group and 9.3% in MC group while median hospital stay was 1 day for LC and 2 days for MC group while patient satisfaction was 90% for LC and 80% for MC group. MC [Minilaparotomy Cholecystectomy] is a safe and feasible technique in which minimal invasiveness of LC [laparoscopic cholecystectomy] is preserved, so advocating MC for those patients who do not need to return to work early and who are also concerned with cosmetic result

Estenosis biliar postoperatoria media por neuroma de amputación del plexo pericoledociano / Post-operative mediate biliary stenosis due to amputation neuroma of pericholedochal plexus

Dos antiguos coledocotomizados hicieron estenosis tardías de la vía biliar principal (3 años y 1 año). Ambos fueron tratados con resección de la estrictura y anastomosis hepático-yeyunal. El estudio histológico mostró neuromas de amputación en los dos casos. Esta rara lesión ha sido comunicada en muy pocas ocasiones en la literatura que se refieren en el texto

Choledochoduodenostomy, its role in the management of patients with gall bladder stones

413 patients presented with benign biliary tract pathology. Out of 328 patients who have had cholecystectomy performed for gall bladder stones, 16 had choledocho-duodenostomy done. 85 patients had calcular obstructive jaundice and out of these, 26 patients had choledocho-duodenostomy. In total 42 patients had choledocho-duodenostomy done for various indications. There was no postoperative mortality. Postoperative complications occurred in 8 patients [19%]. The follow up period varied between one and eight years. During this period seven patients died due to casuses other than their biliary tract condition. The remaining 35 patients are symptom free up to the last follow up visit. This study has shown that there is still a place for such procedure in the management of patients with benign biliary tract pathology. It proved to be a safe procedure with no mortality, in this series, and an insignificant morbidity