value of splenic vicryl mesh repair in cases of rupture spleen

Twenty-three patients [15 males and 8 females] with rupture spleen; grade II in 3 cases [13.04%], grade IIl in 12 cases [52.17%] and grade IV in 8 cases [34.78%] had been managed with splenic preservation and vicryl mesh application. Splenic salvage with mesh was done in 20 cases [86.96%] while in the remaining 3 cases [13.04%] partial splenectomy was done followed by mesh application. The vicryl mesh was successful in controlling splenic bleeding in all cases [100%]. However, re-exploration was performed in two cases for causes other than bleeding. The first case was explored due to peritonitis from disrupted gastric tear and splenectomy was performed. The second case was explored due to small bowel gangrene and resection anastomosis was done with preservation of the mesh and the patient was discharged after 10 days. One patient died in the first post-operative day suffering from cerebral laceration. One week after the operation duplex scanning demonstrated normal flow in the splenic vessels in the surviving 22 cases and IgG, IgA and IgM were found to be within normal limits. The application of splenic mesh for preservation of injured spleen is a safe and reliable method for splenic salvage and maintenance of splenic function

Complications of laparoscopic cholecystectomy in 100 consecutive non selected cases

A prospective study of 100 consecutive non selected patients who underwent laparoscopic Cholecystectomy in surgical unit-I of Sir Ganga Ram Hospital is presented. The mean age of the patients was 42 years, 94.8% cases were female and rest [5.2%] were male. Most [97%] belonged to urban area and rest [3%] to rural area. Eighty nine Percent were admitted through out patient department and 11% as emergency. Pain right hypochondrium was the commonest symptom [80%]. The conversion rate was 16%, due to adhesions, inflammation, hypotension, and bleeding. Incidence of complications was 5% in the form of Richter's Hernia, common bile duct injury, biloma formation, subhepatic abscess and wound infection. There was no mortality in the series. The mean hospital stay remained 2 days