[Inguinal hernia - review].

Inguinal hernia is the most frequently diagnosed hernia and during their lifetime one third of males are diagnosed with an inguinal hernia. The age distribution is bimodal with the highest incidence in childhood and after 50 years of age. Diagnosis is usually reached through clinical examination of a lump in the inguinal region although some patients can present with intestinal obstruction. Inguinal hernia repair is the only definitive treatment and is one of the most common surgical procedures performed. It is usually performed as an elective procedure in local, spinal or general anasthesia. The repair constitutes of reinforcing the posterior wall of the inguinal canal, often using a polypropylene mesh; either via an open anterior approach or posteriorly from within the abdomen with laparoscopy. The most common complications following a hernia repair are recurrent hernia and chronic -discomfort but recurrence rates have improved with the use of mesh and laparoscopic techniques. This evidence based review describes the -epidemiology and etiology of inguinal hernia together with the most common surgical procedures; focusing on recent innovations.

[Results of cholecystectomies 2003-2010 in a small hospital in Iceland].

AIM: Cholecystectomy is a common procedure in general surgery. The aim of this study was to retrospectivly assess the results of cholecystectomies performed in Akranes Hospital (AH), a small hospital in Iceland. MATERIAL AND METHODS: This retrospective study included all patients that underwent a cholecystectomy in AH from 1 January 2003 to 31 December 2010. Patient records were reviewed from AH, as well as from Landspitali University Hospital and Domus Medica. RESULTS: 378 operations were performed. 74% of the patients were women and the mean age was 49.6 years. The majority of operations were elective (87%) and the median operative time was 46 minutes (range: 17-240). The median length of stay was 2 days (range: 1-31). Intra-operative cholangiography (IOC) was performed in 93 of 378 patients (25%). Endoscopic retrograde cholangiopancreatography, ERCP, was performed consecutively in 22 of those 93 patients (23%). The conversion rate to open surgery was 0.5%. The rate of serious complications was 2.4% of which four (1.1%) patients had a deep infection and 5 (1.3%) had a bile leakage postoperatively. Patients with cholecystitis had an increased risk of serious complications (p=0.007). Reoperation was performed on three patients who had bile leakage. No patient had a serious bile duct injury and mortality was 0%. 254 (67%) patients had 4 week control postoperatively where 13 patients (5%) had mild gastrointestinal symptoms. CONCLUSION: The results of cholecystectomies in AH are very good and comparable to the results of national and international studies. Key words: laparoscopic cholecystectomy, intra-operative cholangiography, choledocholithiasis, endoscopic retrograde cholangiopancreatography, complications. Correspondence: Marta Ros Berndsen, mrberndsen3@gmail.com.