Purpose. To identify the prevalence, types, and patterns of colonic polyps in a cohort of patients presenting to a tertiary care referral center in Sri Lanka. Methods. Endoscopy and pathology reports of a single unit from 2006 to 2013 were analyzed retrospectively. Spearman's correlation coefficient and chi-square test were used to identify correlations. Results. There were a total of 158 patients (M : F, 10 : 57) who had polyps encountered on colonoscopy (n = 1408) and flexible sigmoidoscopy (n = 2402) with an incidence of 4.1%. Mean age was 56.5 years (SD 16.4) and the incidence of polyps increased with age. The majority (81.6%) had one polyp. A total of 188 polyps were assessed and most were seen in the rectum (33.5%) followed by sigmoid colon (22.9%). The commonest histological type was tubulovillous adenoma (33.5%) followed by tubular adenoma (24.5%). Most polyps were benign (91.5%). There was no statistically significant correlation with age or gender with malignancy, site, or histology. Discussion and Conclusion. The incidence of colorectal polyps was lower than the values reported in the west. More polyps were identified in males. There was no statistically significant association between age, gender, or multiplicity and malignant change in the polyps.
Three consecutive patients undergone robotic reoperation by daVinciÒ SI, and by the same team were reported. Patients were positioned in reverse Trendelenburg. For all patients, five trocars were used (3 of 8 mm and 2 of 12 mm), and surgical specimens were removed through Pfannestiel incisions. Results: From November 2016 to December 2017, three cases of IGBC were performed. Clinicopathological, operative and postoperative data are summarized in the table. Briefly, all patients underwent bisegmentectomy IVb/ V (1 anatomical and 2 non-anatomical) plus hilar lymphadenectomy; they were pT1b, and neither presented residual liver disease nor positive node at final pathology. Neither Pringle maneuver nor blood transfusions were necessary. All discharges from ICU and hospital were on second and third postoperative days, respectively. No complications at 30-days were recorded. Conclusion: Our initial experience suggests that robotic reoperation seems to be safe, and simplifies both hilar lymphadenectomy as well as intrahepatic control of pedicles allowing anatomic resections. The putative benefits of its approach are the articulate arms facilitating traction and dissection of hilar structures with precise movements and tridimensional view. Both articulate mono and bipolar scalpels helped to work bi-axially on the liver wedge necessary to remove segments IVb/V with their pedicles.
Introduction: Laparoscopic cholecystectomy is the standard care for symptomatic gall stone disease. Although open cholecystectomy has a longer convalescence, it is considered a safe approach when difficulties are encountered during laparoscopic surgery. Though Studies have shown many risk factors for conversion the effect of preoperative ERCP is scarce worldwide. Methods: Two hundred and two consecutive laparoscopic(LC) and laparoscopy converted to open(LCOC) cholecystectomies performed on patients attending a tertiary referral centre from 2014 to 2016 were analysed using SPSS version 20.0 Results: One hundred and thirty three LC and 69 LCOC were done with a conversion rate of 34.1%. Majority were females(76%). Mean age was 46.35 years(range 16e80). Demographic data and surgical factors are comparable in both groups. All patients with choledocholithiasis underwent ERCP prior to cholecystectomy. Fifty two percent and 6% had ERCP pre operatively in LCOC and LC groups respectively(OR -13.9, 95% CI 5.8-32.9). Eighty one percent of the patients who underwent ERCP had a conversion(p < 0.001). ERCP with common bile duct stenting(11%) had no significant correlation with the conversion. There is no significant association between number of ERCP and conversion(Median -2, Range 1-5).Mean duration after ERCP to surgery was 20.3 weeks(range-2-48 weeks) in LCOC group. No bile duct injuries were reported in both groups. Conclusion: High conversion rate of our case series could be due to the complexity of the referrals. ERCP is a significant risk factor for conversion according to our data. Post ERCP patients should be informed about the higher risk of conversion. Inflammatory myofibroblastic tumors are rare benign tumors that can mimic malignancy of unknown aetiology. It has spectrum of myofibroblastic proliferation along with varying amount of inflammatory infiltrate. Recently, the concept of this lesion being reactive has been challenged based on the clinical demonstration of recurrences and metastasis and cytogenetic evidence of acquired clonal chromosomal abnormalities. We hereby report a case series of three patients with inflammatory myofibroblastic tumour involving gallbladder, liver.Inflammatory myofibroblastic tumor (IMT) occurs more frequently in childhood and the most common involvement is seen in the lungs. Primary inflammatory myofibroblastic tumors of the gallbladder are rather infrequent. The present knowledge is based on case reports. Initiating factors such as reactive, infections, autoimmune and neoplastic processes, has been proposed but the etiology of most remains unknown. The most frequently involved organ in the abdomen is the liver, while primary gallbladder involvement is quite rare. Present knowledge about this entity is based on case reports in the literature (9). The clinical picture in cases with IMT depends on the organ of involvement and site of the organ; abdominal pain, jaundice and ascites might be the presenting symptoms, according to the localisation in the liver involvement.In our cases symp...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.