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Purpose: Several studies have reported that laparoscopic cholecystectomy with percutaneous transhepatic gallbladder drainage (PTGBD) is associated with a reduced duration of surgery and a lower rate of conversion to open laparotomy compared with laparoscopic cholecystectomy without PTGBD and delayed laparoscopic cholecystectomy after conservative therapy. However, these results are contradictory. This retrospective study investigated the safety and usefulness of laparoscopic cholecystectomy combined with pre-operative PTGBD in patients with acute cholecystitis. Methods:The clinicopathologic data and surgical outcomes of 101 patients who underwent laparoscopic cholecystectomy between January 2010 and September 2015 were reviewed retrospectively. Results:Patients in the PTGBD group vs. the non-PTGBD group were significantly older (mean age: 65.47±12.2 vs. 56.32±13.7; p=0.001). Underlying diseases were also significantly more common in the PTGBD group (75.4% vs. 45.5%; p=0.002). There were no significant differences between the two groups in terms of operative time, blood loss, rate of open conversion, postoperative oral intake, and postoperative hospital stay. Total hospital day was significantly longer in the PTGBD group (11.14±7.22 vs. 6.23±5.17; p=0.049). There was no significant difference in the postoperative complications between the two groups, and all patients in this study lived. Conclusion:This study suggested that satisfactory results can be achieved with selective preoperative PTGBD in older and sicker patients with acute cholecystitis.

Various volatile organic compounds (VOCs), including aldehydes, are present in fried food being cooked in high-temperature oil. In this study, real-time VOC concentration was measured in the upper part of a large pot in the cooking room using Proton Transfer Reaction Time-of-Flight Mass Spectrometry (PTR ToF MS) for 3 days (roasted on the first day, fried on the second day, and simmered on the third day). The average concentration of diacetyl was the highest on the first day of stir-frying and steaming. The highest concentrations of formaldehyde was on day 3 when pork was cooked in sugar and sauce. Formaldehyde, 1,3-butadiene, acrolein, diacetyl, and naphthalene were detected during the frying process on the second day, and were detected in descending order of boiling point. In addition, various VOCs such as methanol were detected. The maximum/minimum concentration ratio was the highest for acrolein (3,030), so it was confirmed that many aldehydes were generated during frying. Although there is a limit to direct comparison with Occupational Exposure Limit as a result of area sample by PTR ToF MS, the mean concentrations of formaldehyde and diacetyl during the frying operation for 15 minutes were 232 ppb and 16 ppb, respectively, which was 80% of the American Conference of Governmental Industrial Hygienists Threshold Limit Value-Short Term Exposure Limit. After the frying was over, the VOC concentration began to decrease, and it took more than 3 hours to lower the VOC concentration to the level before the oil was heated. As various harmful gaseous substances are generated when cooking deep-frying, improvement methods such as using oil with high boiling points and developing respiratory protection programs should be devised.

Open adhesiolysis has been the favored approach regarding surgical management of intestinal obstruction. Following the development of laparoscopic devices and necessary surgical techniques, laparoscopic treatment of intestinal obstruction and adhesion has been tried in highly selected cases. Our study was designed to investigate laparoscopic adhesiolysis to treat intestinal obstruction. Methods: The clinicopathologic data and surgical outcomes of 14 patients who underwent emergency laparoscopy between January 2007 and April 2015 were retrospectively reviewed. Results: Five patients had a history of abdominal surgery, and twelve patients had adhesive intestinal obstruction. The causes of adhesive intestinal obstruction included tuberculous peritonitis, periappendiceal abscess, serosal fibrosis and chronic inflammation of intestine, gastric volvulus by fibrotic band. Two patients had non-adhesive intestinal obstruction, caused by intussusception and small bowel ulcer with stricture. The mean surgical time was 98.5 minutes, with mean blood loss of 35 ml. One case was converted to open surgery (7.1%). The mean postoperative hospital stay was 6.5 days. The mean time to oral intake was 3.4 days. There were no postoperative complications or deaths. Conclusion: When the patients are selected carefully in accordance with the guidelines, in our experience laparoscopic adhesiolysis is safe and feasible.