Laparoscopic adrenalectomy has been shown to be as safe and effective as conventional open surgery for small and benign adrenal lesions. With increasing experience with laparoscopic adrenalectomy, this approach has become the procedure of choice for the majority of patients requiring adrenalectomy. In our department, from 2011 to 2016, a total of 28 patients with 31 adrenal tumours underwent laparoscopic adrenalectomy regardless of tumour size. Our policy in the department is to exclude adrenal tumours that are potentially malignant or metastatic adrenal tumours for laparoscopic resection. In this a retrospective study, we divided patients into two groups according to tumour size: < 5 or ≥ 5 cm, which was considered as the definition of large adrenal tumours. We compared demographic data and per- and postoperative outcomes. There was no statistical difference between the two groups for per-operative complications (16,6% vs 18,75% , P = 0.71), postoperative complications (16,6% vs 18,75% , P = 0.71), postoperative length of hospital stay (5 vs 8 days P = 0.40), mortality (0% vs 0%) or oncologic outcomes: recurrence and metastasis (8.3% vs 6.25% P = 0.70). The only statistical difference was the operating time, at a mean (SD) 194 (60) vs 237 (71) min (P = 0.039) and the conversion rate (0% vs 12.5% P < 0.01). Laparoscopic adrenalectomy can be done for all patients with adrenal tumours regardless of tumour size, even it needs more time for large tumour but appears to be safe and feasible when performed by experienced surgeons.

Small bowel tumors are rare, rating between 1% and 6% of all gastrointestinal tumors [1]. The association of small bowel tumor is reported in Crohn's disease (CD) [2]. We report a case of a 40-year-old female patient with a history of Hemorrhagic Recto-colitis admitted for an occlusive small bowel tumor, treated by a carcinologic resection.

Spigelian hernia is rare and accounts for less than 0.1% of abdominal wall hernias. It is often diagnosed at the complication stage. Authors report the case of a 48-year-old obese patient who had a painful swelling of the right iliac fossa. Morphological examination data were in favour of a strangled spigelian hernia and surgical exploration had shown a hernial sac with epiploic contents with a narrow collar. It was performed a resection of the retracted epiploon with simple raphy. The postoperative course was uneventful. Diagnostic and therapeutic difficulties are discussed through a literature review.

Background: Liver hydatid is a parasitic disease considered benign but can become dangerous because of its complications. The fistula in biliary tract remains one of the most feared complications by its frequency, morbidity and mortality. Materials and methods: We present a descriptive and comparative retrospective study at the university hospital Hassan II of Fez. This study was carried out on 63 cases of angiocholitis on hydatid cyst of the liver fistulized in the bile ducts and extends over a period of 5 years from January 2015 to December 2019. The objective of this study is to evaluate and compare the contribution of different therapeutic modalities in the treatment of cystic biliary fistula (Surgical treatment against endoscopic treatment). Results: Surgical treatment was used in 22 patients against 41 patients who underwent endoscopic treatment. The success rate of endoscopic treatment was higher than that of surgical treatment (83% against 73 %, p = 0.350). The mortality rate was reduced in the endoscopy group compared with patients in the surgery group (5% against 14 %, p = 0.226). General morbidity and major morbidity were higher significantly in patients treated surgically (General morbidity: surgery 41% against 2% for endoscopy, P0.05). Conclusion: Endoscopic treatment should be considered as the treatment of choice for angiocholitis due to hydatid cyst of the liver fistulized in the bile ducts.

Background: Liver hydatid is a parasitic disease considered benign but can become dangerous because of its complications. The fistula in biliary tract remains one of the most feared complications by its frequency, morbidity and mortality.Materials and methods:We present a descriptive and comparative retrospective study at the university hospital Hassan II of Fez. This study was carried out on 63 cases of angiocholitis on hydatid cyst of the liver fistulized in the bile ducts and extends over a period of 5 years from January 2015 to December 2019. The objective of this study is to evaluate and compare the contribution of different therapeutic modalities in the treatment of cystic biliary fistula (Surgical treatment against endoscopic treatment).Results: Surgical treatment was used in 22 patients against 41 patients who underwent endoscopic treatment. The success rate of endoscopic treatment was higher than that of surgical treatment (83% against 73 %, p = 0.350). The mortality rate was reduced in the endoscopy group compared with patients in the surgery group (5% against 14 %, p = 0.226). General morbidity and major morbidity were higher significantly in patients treated surgically (General morbidity: surgery 41% against 2% for endoscopy, P0.05Conclusion:Endoscopic treatment should be considered as the treatment of choice for angiocholitis due to hydatid cyst of the liver fistulized in the bile ducts.

Diverticulosis of the small intestine in adults is rare [1], it is much less frequent in the jejunum than in the colon [2], the main complication of jejunal diverticulosis is perforation. We report the case of a 68-year-old patient in whom a proximal jejunal diverticulum was discovered incidentally.

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