elective sublay umbilical hernia mesh repair is a safe approach and feasible technique in selected non-complicated cirrhotic patients with ascites.

No abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) with consequent laparoscopic cholecystectomy (LC) has been the favored approach for the treatment of choledocholithiasis for a long time; however recently, laparoscopic common bile duct exploration (LCBDE) has been offered to patients with suspected choledocholithiasis. Objective and aim of this work was to compare the efficacy, safety, and the surgical outcomes of LCBDE with ERCP followed by LC and determine the most appropriate approach for patients with choledocholithiasis.Methods: A prospective clinical study was carried out from March 2017 to September 2018. It included 50 patients with cholecysto-choledocholithiasis who were divided into two groups: group A (25 patients) included patients who underwent transcystic LCBDE and stone extraction with LC in one stage, and group B (25 patients) included patients who underwent ERCP followed by LC in two stages. The common bile duct (CBD) stone clearance rate, postoperative bile leakage, postoperative morbidity, mortality, overall hospital stay, and patient satisfaction were analyzed.Results: LCBDE and ERCP+LC were similar in terms of clearance rate, operative time, postoperative complications, retained CBD stones, and postoperative length of stay, but there was a significant difference in number of procedures and patient satisfaction.Conclusions: Although both approaches have equivalent success rates, LCBDE is better in terms of fewer procedures, and better satisfaction compared with ERCP + LC. Our study suggests that one-stage management is the treatment of choice for patients with cholecysto-choledocholithiasis.

No abstract

In uncomplicated gall bladder disease; single incision laparoscopic cholecystectomy is feasible and safe. It has an excellent esthetic results and high grade of patient satisfaction. It could be performed with the conventional laparoscopic instruments and its scale of application could be widened once enough experience attained.

Background: The optimal surgical approach of inguinal hernia in patients with liver cirrhosis; laparoscopic or open; is still undefined. Whether laparoscopic inguinal hernia repair is safe and potentially affords superior outcomes in patients with liver disease is unknown. Aim of this study is to assess the outcomes of laparoscopic inguinal hernia repair compared to open procedures regarding postoperative complications and recurrence rate in patients with liver cirrhosis.Methods: This study involves data of ninety patients with primary unilateral inguinal hernia and liver cirrhosis. 48 of them had Lichtenstein repair and 42 patients had laparoscopic inguinal hernia repair with the total extra-peritoneal (TEP) approach.Results: The mean operation time was greater for the patients operated by TEP than that by Lichtenstein repair with a statistically significant difference (p=0.02). Wound infection, scrotal edema and hospital stay were greater for the patients operated by Lichtenstein repair (p=0.0001 for all). At a mean follow-up of 16.9 months (range: 2 –32 months); recurrence of hernia developed in 3 (3.1 %) with Lichtenstein repair but no recurrence of hernia occurred in the patients operated with TEP.Conclusions: Elective Laparoscopic inguinal hernia repair is feasible option in liver cirrhosis patients. However; despite of some better outcomes with TEP; there is insufficient evidence to conclude its greater effectiveness than Lichtenstein repair.

No abstract

No abstract