Although laparoscopic cholecystectomy is a safe procedure, the rate of conversion to open cholecystectomy is still substantial. The conversion rate depends both on the indication and intraoperative complications. There is still a 10.38% morbidity associated with the procedure; however, the incidence of common bile duct injuries, which decreases with growing laparoscopic experience, was relatively low.

This report describes the case of a 73-year-old patient who presented with symptomatic uncomplicated liver cysts. Treatment of this case by laparoscopic surgery is described and a short review of the literature is presented.

Laparoscopy improves diagnostic accuracy for acute appendicitis and laparoscopic stapling appendectomy is a safe and efficient procedure for all forms of appendicitis.

The introduction of laparoscopic gastric banding appears to have revolutionized bariatric surgery. This review presents this new method in terms of indications, operative technique and preliminary results according to our own experience as well as reports in the literature. It seems that a long-term weight reduction of more than 50% excess weight can be achieved with a low morbidity rate. In the near future laparoscopic gastric banding can possibly become the procedure of choice for the treatment of morbid obesity.

Intraoperative cholangiography performed during laparoscopic cholecystectomy provides an exact picture of the biliary anatomy. It may prevent iatrogenic bile duct injury and detect unsuspected common duct stones. Laparoscopic cannulation of the cystic duct can be difficult and time-consuming. We therefore evaluated the simpler technique of cholecystocholangiography by direct puncture and filling of the gallbladder with contrast medium. This technique was compared with cystic duct cholangiography in a prospective controlled trial of 69 patients. Cystic duct cholangiography (n = 38) showed significantly better results than cholecystocholangiography (n = 31) with optimal visualization of the biliary tree in 29 cases (76%) and seven cases (22%), respectively. The failure rate was 8% and 52%, respectively. Delineation of the cystic duct junction is important in order to prevent bile duct injury. The anatomy in this region was clearly delineated in 34 cases (89.5%) using cystic duct cholangiography but only in 11 cases (35.5%) with cholecystocholangiography. Cystic duct cholangiography revealed unsuspected common duct stones in three cases; however, choledocholithiasis was missed by cholecystocholangiography in at least two patients. Cystic duct cholangiography is clearly the optimal technique. In situations of unclear anatomy in which safe dissection of the cystic duct is not possible, cholecystocholangiography remains a useful alternative.

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Laparoscopy improves diagnostic accuracy for acute appendicitis and laparoscopic stapling appendectomy is a safe and efficient procedure for all forms of appendicitis.

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