Background: Congenital anamolies of extrahepatic biliary apparatus and pancreas have long been recognized and are of clinical importance because when present may surprise the surgeon during surgery and lead to iatrogenic injuries. Surgeries on extra-hepatic biliary apparatus and pancreas are regularly performed throughout the world. Thus insight into the normal anatomy and congenital variations will reduce complication and definitely improve outcome.Methods: Study was conducted in department of surgery GMC Bhopal and dissection was carried out in Department of Forensic Medicine on 100 cadavers with approval from ethical committee.Results: In 100 cases 70 were male and 30 female. The most common variation in extra hepatic biliary apparatus was short cystic duct was found in 6% cases then formation of common hepatic duct by union of right hepatic duct and left hepatic duct was intrahepatic in 3% cases. There was low insertion of cystic duct with common hepatic duct in 1% case. Cystic artery originating from left hepatic artery in 1% case, in 1% case cystic artery was anterior to common hepatic duct. In Pancreas anterior arterial arcade was absent in 2% cases and its origin varied in 2% case. Posterior pancreatic arcade absent in 1% cases and variation in origin was present in 1% case. The variation in pancreatic duct course was present in 22% cases.Conclusions: Thus significant variation was seen and it could definitely be helpful to hepatobiliary, laproscopic surgeons, radiologist and will further contribute to literature on variation of extrahepatic biliary apparatus and pancreas and its related vessels.
Background: Liver abscess is a common condition in India and it has the 2 nd highest incidence of liver abscess in the world. Pyogenic abscess accounts for three quarters of hepatic abscess in developed countries while amoebic liver abscess causes two third of liver abscess in developing countries. Amoebiasis is presently the third most common cause of death from parasitic disease. The world health organisation reported that Entamoeba histolytica causes approximately 50 million cases and 1,00,000 deaths annually. Liver abscess continues to be a disease with considerable mortality in India. Liver abscess has an increasing incidence rate in United States and Europe. Modern treatment has shifted towards IV broad spectrum antibiotics and image guided percutaneous needle aspiration or percutaneous catheter drainage and surgical drainage. Treatment of liver abscess has improved significantly with the introduction of ultrasound and computed tomography. Methodology: This was a retrospective observational study conducted in Department of Surgery, GMC Bhopal, from March 2012 to march 2018. 651 patients were included in this study with the diagnosis of liver abscess. Results: Out of 651 patients, 297 ultrasound guided needle aspirations were done and 246 (83%) responded to it; 354 ultrasound guided pigtail catheter placements were done and 334 (94.3%) responded to it. Most common symptoms were pain in abdomen (n=559), fever (n= 558), nausea and vomiting (n = 455) and weight loss (n= 286). Among the successfully treated patients, early alleviation of symptoms, early resolution of abscess cavity, mean hospital stay and average time for clinical improvement were better among catheter drainage group. Conclusion: Majority of patients with un-ruptured liver abscess can be managed without conventional surgical drainage with Percutaneous catheter drainage is a better modality as compared to percutaneous needle aspiration
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