Gastric-type adenocarcinoma of the uterine cervix diagnosed after laparoscopic surgery following preoperative diagnosis of lobulated cervical gland hyperplasia: A report of two cases

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.

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Safety of laparoscopic management of ovarian dermoid cyst

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v5i1.18260 ◽

2017 ◽

Vol 5 (1) ◽

pp. 18-22

Author(s):

Nira Singh Shrestha ◽

Junu Bajracharya ◽

Rachana Saha

Keyword(s):

Laparoscopic Surgery ◽

Hospital Stay ◽

Dermoid Cyst ◽

Preoperative Diagnosis ◽

Laparoscopic Approach ◽

College Teaching ◽

Laparoscopic Management ◽

Duration Of Hospital Stay ◽

Chemical Peritonitis ◽

Ovarian Dermoid Cyst

Background: In the recent years, with the advancement of laparoscopic surgery, management of ovarian dermoid cysts is possible with laparoscopic approach. Concerns regarding safety of the procedure has been raised.Objective: To analyze the safety of laparoscopic surgery done for ovarian dermoid cyst at Kathmandu Medical College Teaching Hospital.Methods: This is a descriptive study done from July 2012 to June 2015. All the cases with the diagnosis of ovarian dermoid cyst managed laparoscopically during the study period were enrolled in the study. Thorough history, clinical examination fi nding and diagnostic modalities were noted. Three port laparoscopy was done for the management of dermoid cyst. Thorough peritoneal lavage with warm saline was done at the end of the procedure in the cases with spillage.Variables like preoperative diagnosis, postoperative diagnosis, and type of surgery performed, rate of spillage, features of chemical peritonitis if any and duration of hospital stay were noted and analyzed.Results: Total 52 cases with the preoperative diagnosis of dermoid cyst were managed with laparoscopy during the study period. Of these, only 46 cases (88.46%) were dermoid cyst on laparoscopy. In majority of the cases (45.65%) diagnosis was incidental by Ultrasound scan done for other indications. Cystectomy was performed in 42 cases (91.30%) and in 4 cases (8.69%) oophorectomy was done. Spillage occurred in approximately 89% of the cases but there were no cases of chemical peritonitis. Duration of hospital stay ranged between 2 to 5 days.Conclusion: Laparoscopic management of ovarian dermoid cyst is a safe procedure.Journal of Kathmandu Medical CollegeVol. 5, No. 1, Issue 15, Jan.-Mar., 2016, Page: 18-22

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