Patients undergoing surgical treatment for calculous disease were considered to have had a partial cholecystectomy performed when a part of the gall bladder wall was retained for technical reasons. Forty patients underwent partial cholecystectomy: for chronic cholecystitis (20), acute cholecystitis (4), Mirizzi's syndrome (14), portal hypertension or partially accesible gall bladder (one patient each). Four patients (10%) developed infective complications and two patients had retained common bile duct stones. In a mean follow up period of 13 months (range 1–36 mths), only 3 patients have ongoing mild dyspeptic symptoms while the rest have remained asymptomatic. Partial cholecystectomy has been found to be a safe and effective procedure in difficult cholecystectomy situations, since it combines the merits of cholecystectomy and cholecystostomy.

Background: External biliary fistula (EBF) following bile duct injury is a serious complication of cholecystectomy. Methods: From January 1989 to December 1994, 37 patients with post-cholecystectomy external biliary fistula were seen at this centre. There were 14 partial, 22 complete and one sub-vesical duct of Luschka injury. Sixteen patients had a controlled EBF at presentation; 10 patients had intra-abdominal collections and seven patients presented with peritonitis. Results: A staged approach to the management of these patients was adopted in which the initial management aimed at creating a 'controlled' fistula. This approach comprised conservative treatment (n = 9), percutaneous catheter drainage of intra-abdominal collections (n = lo), biliary drainage (n = 6), and surgical intervention (n = 7). One patient died because of progressive liver failure in spite of intensive management. Definitive management comprised the surgical repair of biliary strictures wherever indicated, after waiting for the acute problems to settle. Conclusions: By adopting a staged approach along with a judicious use of endoscopy, radiology and surgery that were based on clinical circumstances, it was possible to achieve satisfactory results for this otherwise distressing condition.

We present a case of adult hepatoblastoma. This young female presented with severe acute cholangitis. Preoperative diagnosis was common bile duct (CBD) obstruction with portal vein thrombosis. On exploration she had a tumor mass in the CBD. The unusual features of this case are discussed in this report.

Agenesis of the gallbladder, which is an extremely rare anomaly, may present with biliary symptoms but is virtually impossible to diagnose by such conventional investigations as oral cholecystogram or ultrasonography. We report herein a case of a young man presenting with episodic epigastric pain on whom an ultrasonographic diagnosis of gallstones was made. A gallbladder was not visualized on oral cholecystogram, however, he was subsequently found to have agenesis of the gallbladder, the diagnosis of which was confirmed by intra-operative cholangiography and a postoperative N-2,6-dimethylphenylcarbamoyle methyl iminodiacetic acid scan (HIDA scan). His symptoms responded to antiulcer treatment with upper gastrointestinal endoscopic findings suggestive of oesophagitis and duodenitis.

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