ABSTRACT
Central pancreatectomy (CP) originally done for pancreatic trauma and focal pancreatitis is recently being performed for benign and low grade malignant neoplasm of mid pancreas. It offers the advantage of conserving pancreatic tissue and preserving gastroduodenal-biliary anatomy, important for maintenance of endocrine and exocrine pancreatic function. We reviewed our database between Jan. 2005 and June 2007. Four patients (2 males and 2 females) in the age range of 12 to 55 years underwent CP for a mass in the mid pancreas. Two were known diabetic. Histology reported solid variant of serous cystadenoma (1), solid pseudopapillary tumor (1), focal pancreatitis (1) and ductal adenocarcinoma (1). Postoperatively one patient had transient pancreatic fistula which was managed conservatively. There was no mortality. On follow-up (7 to 43 months) none of the patients required enzyme supplements and diabetes did not worsen. Patient with ductal adenocarcinoma progressed within 7 months. CP may be a viable option for mid pancreatic lesions of benign or low grade malignant potential.
ABSTRACT
BACKGROUND: Surgical site infections (SSI) are the most common complication of gastrointestinal surgery. The most common endogenous organisms encountered are the enteric pathogens. METHODS: We report a rare case of S. enterica var. Weltevreden as a cause of SSI after cholecystectomy and common bile duct exploration. Pertinent literature is reviewed. RESULTS: The infection was due to bile spillage and contamination during surgery. The organism was found to be sensitive only to imipenem, and the patient recovered following intravenous treatment with that carbapenem. CONCLUSIONS: This case illustrates the fact that cholecystectomy with bile spillage is a definite risk factor for SSI. Although controversial, isolation of the pathogen from the bile and the surgical site must be made to allow this rare pathogen to be identified. Appropriate antibiotic could then be directed against the pathogen.
