Background: Acute pancreatitis is an acute inflammation of the pancreas resulting from an auto-digestion of the gland. Acute pancreatitis represents a spectrum of disease ranging from a mild, self-limited course to a rapidly progressive, severe illness. In 20–25% of acute pancreatitis are severe, characterized by the development of pancreatic or peri-pancreatic necrosis, resulting in general and local complications responsible for a high mortality rate. The most common indication for intervention in acute pancreatitis is for the treatment of complications and most notably the treatment of infected walled off necrosis. Aims: The aim is to study the intervention to surgery and its outcome in managing severe acute pancreatitis and its complications. Methods: A total of 36 patients with severe acute pancreatitis with its complications not responding to conservative treatment were studied. In this prospective observational study, patients were divided based on the mode of treatment received: percutaneous drainage with pigtail catheterisation, endoscopic cystogastrostomy/drainage procedure and necrosectomy (in patient failed to respond by other intervention). Results: In our study, out of 36 patient 22 patient are treated with percutanous drainage with pig tail catheterization,8 patient are treated with endoscopic cystogastrostomy,6 patient underwent necrosectomy (3 patient underwent minimally invasive laparoscopic necrosectomy and 3 underwent open necrosectomy).Higher complication occured in patient underwent surgical intervention.Mortality occurred in 80% of patient who underwent necrosectomy. Most common cause of death is sepsis with multi organ failure. Conclusion: Surgeons have an important contribution to make in the multidisciplinary care of patients with complicated acute pancreatitis .Patients with acute pancreatitis should be managed conservatively in a step up approach. Early surgical intervention is not recommended even for necrotizing pancreatitis. Infected..

Background: Obesity is an established risk factor for gallstones. Body mass index (BMI) is a calculation index of general obesity. Waist circumference (WC) is a measure of body fat distribution and always used to estimate abdominal obesity. Using one single measure of obesity could not estimate persons at risk for Gallstone disease precisely. Aims: To Study if there any change in trend of relationship between body mass index/ waist-to height ratio in cholelithiasis patients. Objectives: To associate BMI and waist to height ratio with cholelithiasis. Materials and Methods: Type of study: Descriptive study. Sample size: 90 consenting patients diagnosed to have gallstone disease. Place of study: Department of General Surgery KIMS Hospital Bengaluru. Results: In the present descriptive study, 90 cases diagnosed with gallstone disease were selected by purposive sampling technique. They were between the ages of 21-80 years. Out of the ninety cases, thirty were males (33%) and sixty were females (67%). The female to male ratio was 2:1 Maximum number of cases were seen in the 31-40 and 41-50 year age groups that is forty four cases (48%). With peak incidence in 3rd decade. Body mass index was above normal in fifty nine patients (66%). Waist to height ratio was found to be above normal in sixty one patients (68%). suggestive of strong association with obesity. Conclusion: From the present descriptive study conducted at Department of General Surgery, KIMS Hospital Bengaluru is concluded that obesity has a strong association with gall stone disease, the main indicators of obesity being body mass index and waist to height ratio. The dictum of gall stone disease stating, the disease being more common in a “fertile fatty female of forties” is still valid.