INTRODUCTIONThe so-called Schloffer tumor (ST) is a rare inflammatory pseudotumor. It usually appears several years after abdominal surgery or trauma.PRESENTATION OF CASEA 32-year-old man was referred to our hospital complaining of a painful mass in the left hypochondrium, postprandial distension and a weight loss of about 14 kg. He had had a left inguinal hernioplasty without mesh the previous year. Ultrasonography of the abdomen showed a 2 cm × 2 cm hypoechoic lesion in contact with the abdominal wall. Computerized tomography of the abdomen showed a heterogeneous mass in the great omentum.Laparoscopic exploration revealed an omental mass firmly attached to the abdominal wall. A great deal of purulent fluid spread during the procedure. Due to the difficult exploration, the procedure converted to hand assisted laparoscopy. We find an omental tumor involving the stomach and the transverse colon. Inside the mass there were purulent material and non-absorbable sutures. A drain was left inside the cavity of the abscess. Histological examination showed chronic inflammation.DISCUSSIONST characteristically presents a central chronic abscess containing non-absorbable sutures. It has been described after appendectomy, hernioplasty, hysterectomy, gastrectomy or colonic resections. Although benign, its progressive growth and infiltrating behavior resemble malignant tumors.CONCLUSIONWe suggest that a mini-invasive approach should always be performed. The interesting thing about this case is the appearance of the tumor in a place far away from the previous surgical site. A simple drainage and removal of suture material solves the problem of these patients.
Background: The prevalence of common bile duct stones associated with cholelithiasis increases with age and is about 15 % in the 8th decade of life but its management is still controversial. Some surgeons prefer the single-stage approach with laparoscopy while others suggest the two-stage management with preoperative endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy. Objective: The aim of the present study was to evaluate the efficacy of feasibility of single-stage laparoscopic surgery in patients with cholelithiasis and choledocholithiasis. Material and methods: We conducted a retrospective study with prospectively collected data between July 2008 and July 2018. Results: Of 2447 laparoscopic cholecystectomies performed during the study period, 416 presented common bile duct stones. The global success of the transcystic approach to clear common bile duct stones was 81.2%, 70.4% in the cases with preoperative diagnosis of choledocholithiasis and 92.9% for other diagnoses. The rate of complications was 4% without deaths or bile duct injuries. Conclusion: Single-stage laparoscopic surgery is an efficient and safe approach based on the high global success of transcystic exploration. The preoperative diagnosis of choledocholithiasis reduces the efficacy of the procedure due to greater indication of choledocotomy, with complications and longer length of hospital stay.
Congenital biliary duct cysts are rare and are defined as cystic dilatations of the biliary tree in any of its portions. Cystic duct cysts are more uncommon. Their etiology remains uncertain and they should be resected due to the possible development of malignancy. We report the case of a female patient with a diagnosis of dilation of the cystic duct that was treated with laparoscopic surgery
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