Introduction: The development of laparoscopic colorectal surgery began in 1991. Today, laparoscopic surgery presents standard approach in the surgical treatment of malignant colon and rectal diseases. Aim: Surgical and oncological outcomes and survival rates of laparoscopic colorectal surgery at the Oncology Institute of Vojvodina. Methods: Data were collected prospectively from 66 patients undergoing laparoscopic colorectal surgery between December 2009 and December 2019. Registered data included sex, age, surgical indication and type for the procedure, indication and reason for conversion to open surgery, operative time, performing temporary or permanent stoma, intraoperative bowel perforation, pathologic TNM grade, number of harvested lymph nodes, inclusion of positive resection margin, number of postoperative days at the hospital, postoperative complications, postoperative mortality, presence of distant metastases and survival rates. Results: Laparoscopic procedures were right hemicolectomy in 11/66 (16.7%), left hemicolectomy in 1/66 (1.5%), sigmoid colectomy in 19/66 (28.8%), high anterior rectal resection in 13/66 (19.7%), low anterior rectal resection in 12/66 (18.2%), abdominoperineal amputation of the rectum in 7/66 (10.6%), colectomy in 2/66 (3%) and proctocolectomy in 1/66 (1.5%) patient. The median follow-up was 37.5 months (range 6 to 128). The total number of surviving patients was 60 (90.9%). Conclusion: This study showed that laparoscopic colorectal surgery has good clinical and oncological outcomes.
Introduction. Hepatolithiasis (HL) is defined as gallstones present in bile ducts above the common bile duct confluence, regardless of the coexistence of gallstones in other parts of the biliary tract. HL is common among patients with recurrent pyogenic cholangitis. Chronic infection can lead to the development of malignancy. Case outline. A 65-year-old woman presented with intermittent fever, jaundice, abdominal pain, and nausea. Eighteen years ago, patient had an open cholecystectomy due to acute cholecystitis. During the early post-operative days patient developed icterus. Intrahepatic biliary ductal dilatation was confirmed by abdominal ultrasound. Due to suspicion of iatrogenic common bile duct injury patient underwent second operation during which said injury was confirmed. ?Non-Roux-en-Y? hepaticojejunostomy (HJ) was performed as a problem resolving procedure. Despite performed biliary bypass, patient continued to have episodes of recurrent cholangitis over the eighteen years. Given the patient?s recurrent symptoms and results of MRI consistent with HL, surgical treatment was indicated. A left hepatectomy was performed with Roux-en-Y HJ biliary reconstruction. Post-operative course went without complications and since then patient is symptoms free. Conclusion. The main purpose of treating HL is to eliminate infection which leads to recurrent cholangitis and subsequent hepatic fibrosis. Adequate solution of HL decreases the need for repeated interventions and prevent progression of the disease to cholangiocarcinoma.
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