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Introduction: we assessed the results of laparoscopic cholecystectomy in 176 patients over the age of 70 years. Patients and methods: the study included all patients older than 70 years of age who underwent laparoscopic surgery cholelithiasis during the previous ten years. Variables studied included age, sex, type of operation (programmed/emergency), comorbidity, anesthetic risk, intraoperative cholangiography, conversion to open surgery, number of trocars, reoperation, residual choledocholithiasis, postoperative hospital stay, morbidity and mortality. Results: the study included 176 patients (23.29% men and 76.71% women). The mean age was 74.86 years. The mean hospital stay was 1.27 days, with 16.98% morbidity and 0.56% mortality. Conclusions: laparoscopic cholecystectomy is a safe procedure in older patients. It results in faster recovery, a shorter postoperative stay and lower rates of morbidity and mortality than open bile duct surgery.

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Background: Near-peer teaching is an educational method based on being taught by one or more students who are more advanced in one specific area of the same curriculum. The aim of this study was to analyze outcomes and medical students’ reactions to near-peer teaching in Histology Laboratory session. Methods: Histology Laboratory session was firstly designed as a practical session driven by academic staff, while in our new approach was driven by Histology intern students, which are upper year students in Medicine curriculum. Our near-peer teaching was evaluated using a multiple choice test when half of students had attended the session, the results of which were compared with those from traditional teaching. A reaction evaluation survey was also administered at the end of the course. Results: Multiple choice test results did not showed statistical differences between near-peer and traditional teaching strategies. Results from the reaction evaluation were mostly positive, especially with regard to feeling comfortable in the session taught by intern students and how intern students managed to transmit the information properly. Conclusion: Near-peer teaching in Histology Laboratory practical session is an effective alternative teaching method, with outcomes equivalent to traditional design, and highly valued by undergraduate medical students

Although the Roux-en-Y hepaticojejunostomy is the most common surgical procedure for the treatment of bile duct strictures, providing durable long-term results in most patients, when a stricture is present, the management is more difficult, and a reoperation generally will be proposed. However, balloon dilation and endoscopic stenting using the percutaneous transhepatic or transjejunal approach under fluoroscopic guidance have been suggested as the first step or even as definitive management in treating these patients. We present a case report of a patient with a benign biliary stricture as a consequence of a Roux-en-Y hepaticojejunostomy, who was managed through a translaparoscopic jejunal approach because of an unfixed Roux-en-Y loop. In conclusion, we recommend this strategy as the first step for managing the restricture of Roux-en-Y hepaticojejunostomy in patients with an unfixed Roux-en-Y loop.

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