Background & aim: One of the most common complications in acute cholecystitis surgery is to identify the risk factors for converting laparoscopic cholecystectomy to open surgery. As a result, the aim of the present study was to determine and evaluate preoperative laboratory findings in predicting the severity of cholecystectomy. Methods:In this descriptive cross-sectional study, 122 patients who underwent laparoscopic cholecystectomy and laparoscopic surgery in Shahid Beheshti, Nekouei and Forqani hospitals from September 2016 to September 2017 were performed. Prior to surgery, patient information such as age, gender, and laboratory findings such as: WBC, ALT, AST, T Bill were registered in the checklist. Finally, the difficulty of the operation was divided into two easy degrees (less than 60 minutes and without complications) and difficult (above 60 minutes with complications such as bleeding or open surgery) and all the information was entered into SPSS software version 22. And was analyzed using Mann-Whitney test (due to lack of normal data distribution). In this study, a significance level of less than 0.05 was considered.Results: 28 patients(22.4%) were male and 97 patients(77.6%) were female. The mean age of patients was 44.66 ±13.85 years. The number of difficult operations was 35(28%) and easy operations were 90(72%) and conversion to open surgery occurred in 3 cases. There was a significant relationship between preoperative laboratory findings between AST(p= 0.34), T Bill(p= 0.008), WBC(p=0.0001) and operative severity, but between ALT(p=0.065). no significant relationship was found with the difficulty of cholecystectomy. Conclusion:The results indicated that preoperative laboratory findings could provide valuable data in predicting the difficulty of laparoscopic cholecystectomy. Conversely, in a significant number of cases, the matching of preoperative laboratory findings with surgical findings is unsatisfactory. In this group of patients, the difficulty of the operation and the need for open surgery can only be assessed during laparoscopic cholecystectomy.

Peritoneal dialysis is one of the types of renal replacement therapy which is commonly used in patients with the end-stage renal disease. The cost-effectiveness and easy usage are the advantages of peritoneal dialysis. However, peritoneal dialysis is not always free of a problem and among all of its complications, catheter tip migration and omental wrapping are more common as are considered as the causes of catheter malfunctioning. Different techniques are used to correct the malfunctioning catheters such as manipulator techniques, laparoscopic repositioning with tip suturing, omentectomy and omentopexy. In this article, we are proposing two cases, which had been referred by peritoneal catheter malfunctioning and then received a new method of surgery successfully and didn't have any complications after 36 months follow up. This method could simplify the procedure of operation and urachus ligament and reduce time and cost of the process.