Situs Inversus Totalis in Laparoscopic Sleeve Gastrectomy: A Case Report.

Obesity is a pathology that is increasing in incidence globally and threatens public health. Currently, one of its most effective treatments is bariatric surgery, which has shown the best long-term results. One of the most frequently performed surgical procedures in this area is laparoscopic sleeve gastrectomy (LSG) or vertical sleeve. It is a restrictive technique that has had positive results in weight loss. Situs inversus totalis (SIT) is a strange condition with a low incidence in which thoracic and abdominal organs are on the opposite side of the already-known anatomic site, seen on a sagittal plane. The high demand for laparoscopic bariatric surgeries predisposes surgeons to find rare congenital anomalies in patients. Low prevalence and the anatomic mirror image condition may be challenging even for expert surgeons. Medical teams need to have knowledge of these cases and adjust the technique and procedure to complete the surgery without complications. We present a SIT case successfully treated with LSG in a male patient in Mexico.

[Complications in diagnostic and therapeutic endoscopic cholangiopancreatography. Prospective study]. / Complicaciones en colangiopancreatografía endoscópica diagnóstica y terapéutica. Estudio prospectivo.

BACKGROUND: Studies of ERCP-related morbidity seldom include a sufficient patient follow-up. The complication rate is variable. AIM: To characterize and to evaluate the frequency of complications in patients after Diagnostic and Therapeutic ERCP. PATIENTS AND METHODS: All patients undergoing ERCP during a 2-year period were included in this prospective study. Complications were assessed at time of ERCP and by personal or telephone contact at 1st, 7, 14 and 30-days after the procedure. RESULTS: A total of 897 ERCPs were included in the analysis, of which 93.9% were therapeutic procedures. 640 were female with age of 49.68 (+/-18.59) and 257 male with age 58.80 (+/-16.67). The 30-day complications rate was 3.19%; the procedure-related mortality rate was 0.11%. Mild hemorrhage occurred in 1.48% and moderate hemorrhage in 0.11%. Post-ERCP pancreatitis occurred in 0.79% and duodenal perforation in 0.45%. The 30-day procedure-no related mortality was 1.14%. CONCLUSION: This prospective study confirms the complications rate of ERCP including therapeutic procedures is low in our experience.