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LCBDE is an effective and safe mean of clearing common bile duct stones at community hospitals of an integrated health system. Previously cited contraindications for TLCBDE are not absolute, but rather predictors of failure.

LC/ERCP is better than LCBDE in clearing CBD stones, but has similar morbidity and is an effective alternative for patients with RYGB.

BACKGROUND: motor peripheral nerve injury is a rare but serious event after colorectal surgery, and a nationwide study of this complication is lacking.OBJECTIVE: the purpose of this study was to report the incidence, trends, and risk factors of motor peripheral nerve injury during colorectal surgery. DESIGN: the national surgical Quality improvement Program database was surveyed for motor peripheral nerve injury complicating colorectal procedures. Risk factors for this complication were identified using logistic regression analysis. SETTINGS: the study used a national database. PATIENTS: Patients undergoing colorectal resection between 2005 and 2013 were included.MAIN OUTCOME MEASURES: the incidence, trends, and risk factors for motor peripheral nerve injury complicating colorectal procedures were measured. RESULTS:We identified 186,936 colorectal cases, of which 50,470 (27%) were performed laparoscopically. motor peripheral nerve injury occurred in 122 patients (0.065%). injury rates declined over the study period, from 0.025% in 2006 to <0.010% in 2013 (p < 0.001). Patients with motor peripheral nerve injury were younger (mean ± sD; 54.02 ± 15.41 y vs 61.56 ± 15.95 y; p < 0.001), more likely to be obese (Bmi ≥30; 43% vs 31%; p = 0.003), and more likely to have received radiotherapy (12.3% vs 4.7%; p < 0.001). nerve injury was also associated with longer operative times (277.16 ± 169.79 min vs ± 104.80 min; p < 0.001) and was less likely to be associated with laparoscopy (p = 0.043). multivariate analysis revealed that increasing operative time was associated with nerve injury (oR = 1.04 (95% Ci, 1.03-1.04)), whereas increasing age was associated with a protective effect (oR = 0.80 (95% Ci, 0.71-0.90)). LIMITATIONS:this study was limited by its retrospective nature.CONCLUSIONS: motor peripheral nerve injury during colorectal procedures is uncommon (0.065%), and its rate declined significantly over the study period. Prolonged operative time is the strongest predictor of motor peripheral nerve injury during colorectal procedures. instituting and documenting measures to prevent nerve injury is imperative; however, special attention to this complication is necessary when surgeons contemplate long

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Introduction The development of a penile hydrocele following the placement of an inflatable penile prosthesis (IPP) for erectile dysfunction has never been documented. We herein report an unusual complication of penile hydrocele formation that developed following placement of an IPP for erectile dysfunction. Methods The penile hydrocele was successfully repaired by excision of the hydrocele sac. Results Successful surgical repair of a penile hydrocele was accomplished following placement of an IPP without removal of any implant components. The penile implant was functional at the end of the procedure as well as at all scheduled follow-up appointments. Conclusions With advances in both surgical techniques and improved devise technology, high volume penile implanters encounter fewer IPP-related complications such as infectious or mechanical complications. We herein report for the first time a rare complication of penile hydrocele development after IPP placement that was treated successfully with surgical excision of the hydrocele sac. Urologists who perform these types of procedures should be aware of this unusual complication and know that it is curable with prompt diagnosis and meticulous surgical repair.