New Technique of Posterior Fixation of Tube With Fibrin Sealant Prevents Dysphagia in Patients Undergoing Sleeve Gastrectomy.

INTRODUCTION: This study compared the effects of posterior fixation (PF) of the remnant tube with fibrin tissue glue to prevent sharp angulation and gastric twist and traditional techniques on postoperative dysphagia and vomiting. METHODOLOGY: In total, 200 patients scheduled to undergo laparoscopic sleeve gastrectomy (LSG) as a bariatric surgical intervention were randomly classified into 2 groups (LSG + PF and LSG alone). We compared postoperative dysphagia symptoms among patients who underwent PF and those who did not. The Dysphagia Handicap Index (DHI) results were compared statistically among these groups. RESULTS: The study included a total of 191 patients (85.9% (n = 164) women and 14.1% (n = 27) men) who underwent LSG for obesity. The groups were similar in terms of the patient demographics. The DHI scores of the LSG + PF group were statistically significantly lower than those of the LSG alone group. CONCLUSION: Adoption of a standardized method of PF with a standardized surgical procedure after LSG considerably reduced the rate of surgical complications.

Treatment of Anastomotic Leaks With EndoVac After Low Anterior Resection in Colorectal Cancers.

INTRODUCTION: Endoscopic drainage should preferably be tried unless the abscess caused by the anastomotic leak is generalized and disseminated into the abdominal cavity. The aim of this study was to evaluate the results of patients treated with EndoVac. PATIENT AND METHODS: The medical records of patients who underwent low anterior resection and were treated using the EndoVac therapy system due to the detection of an anastomotic leak were retrospectively evaluated. RESULTS: Thirty-three of the patients with detection of anastomotic leaks were treated using EndoVac therapy system. The mean number of application of the EndoVac therapy system was 5.8 (1 to 12) for each patient. Mean duration of hospitalization of the patients was 24.5 (9 to 92) days. Five patients underwent a second operation during the follow-up period after application of the EndoVac therapy system. In our study, the number of patients recovering without the need for additional treatment is 30 (30/33). Our success rate was 90.1%. CONCLUSIONS: The EndoVac therapy system is an alternative and helpful system in the treatment of colorectal anastomotic leaks without reoperation needed. It can also prevent permanent stoma.

Case report: acute pancreatitis caused by postcholecystectomic hemobilia.

BACKGROUND: Hemobilia is a rare cause of upper GI bleeding and the reasons for the majority of the cases are iatrogenic. It is also one of the rarest vascular complication following laparoscopic cholecystectomy but acute pancreatitis due to postcholecystectomic hemobilia as a late complication of cholecystectomy is not yet described. CASE PRESENTATION: We presented the case of a 32-year-old female, admitted to our emergency surgery clinic with hematemesis, jaundice and abdominal pain who had a history of laparoscopic cholecystectomy 4 months ago. Patient was diagnosed as acute pancreatitis and obstructive jaundice caused by postcholecystectomic hemobilia. Afterwards she is successfully treated by ERCP, angiographic identification and embolization of right hepatic artery pseudoaneurysm. CONCLUSIONS: We presented that postcholecystectomic hemobilia may cause acute pancreatitis and acute pancreatitis caused by postcholecystectomic hemobilia should also be included to the rare complications which may occur following cholecystectomy.