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Background: Post-hepaticojejunostomy stricture is a common problem may result in liver cirrhosis and portal hypertension and death if not treated. Different modalities to repair it are available including endoscopic management that needs access loop (including jejuno-duodenal access loop) to reach the site of stricture.Methods: This prospective study was done in general surgery department, faculty of medicine, Zagazig University hospitals during the period from January 2016 to December 2018. The study included 23 patients (18 females and 5 males) all needed hepaticojejunostomy to treat biliary injuries during cholecystectomy, biliary stricture post-cholecystectomy or post-hepaticojejunostomy anastomotic stricture. Their ages ranged between 26 to 57 ys with mean age 37.3±5.1. The postoperative course of patients and the feasibility of postoperative endoscopic access to the hepaticojejunostomy and intrahepatic ductal system were assessed.Results: This study included 23 patients (18 females and 5 males) where 19 (82.6%) patients were presented post-cholecystectomy and 4 (17.4%) patients post-hepaticojejunostomy, with different modes of presentation postoperative complications included; 2 patients complicated with chest infection, 3 (13%) patients with wound seroma and infection, 2 (about 8.7%) patients complicated with biliary gastritis and 1 (about 4.4%) patient with mild attack of cholangitis. There was no anastomotic leakage or mortality in the studied group. The trial of access to the hepaticojejunostomy using gastroduodenoscopy was successful in all cases with ease including trial of balloon dilatation. The average hospital stay ranged between 5-7 days.Conclusions: Side-to-side jejunoduodenal anastomosis is a very useful technique as it provides good endoscopic access to hepaticojejunostomy and the intrahepatic ducts and needs more application and further evaluation.

EUS-guided transmural endoscopic drainage It can treat the late stages of Acute Necrotizing Pancreatitis (ANP), Walled-off pancreatic necrosis ( WOPN). Still, in the initial stages of ANP, the endoscopic function s not completely clear. Our aim We are comparing endoscopic draining of WOPN with early endoscopic treatment of Acute Necrotizing Pancreatic Collection (ANCs). Methods There were 142 ANP patients with necrotizing pancreatic collection who received transmural endoscopic drainage. In 50 (35.21%) cases with ANC (Group 1) and 92 (64.79%) individuals with WOPN (Group 2), endoscopic drainage was carried out after the first 4 -5 weeks following ANP. Results The patient's average age was 49.9 years (range: 22–79), and 59%of them were male. In Groups 1 and 2, the mean active drainage timing was 26.8 and 16.9 days (P = 0.0001) in Group 1 and 270.8 and 164.2 days (P = 0.0001) in Group 2, there was a medium of 9.5 and 4.5 endoscopic drainages with (P = 0.0001). No significant differences in long-standing success rates between the two groups (P > 0.05 for each). Conclusion Within the first 4-5 weeks later, ANP, transmural endoscopic intervention is an sufficient treating of early ANCs. However, more procedures and a longer duration of treatment following endoscopy in WOPN of drainage are needed.

Background: Chemotherapy plays a significant part in the management of breast cancer. In the current study, mastectomy with prompt breast reconstruction, the effects of neoadjuvant and adjuvant chemotherapy were investigated. Objective: The effect of neoadjuvant and adjuvant were given systemically to breast cancer patients to investigate their effect on breast reconstruction following mastectomy. Methods: Two-year postoperative follow-up at Zagazig University Surgical Department for 82 patients who received assistance systemic neoadjuvant (NAC) and (ACT) adjuvant chemotherapy for breast cancer between January 2021 and December 2022, together with mastectomy and rapid reconstructive surgery of the breast. Results: During the trial, 82 patients received fast breast remodeling after mastectomy. 34 patients did not receive any systemic therapy, whereas 28 patients had preoperative chemotherapy and 20 patients received postoperative chemotherapy. Conclusion: There were no differences in unscheduled reoperation, donor-site complications, or expander loss across the groups although the adjuvant chemotherapy group had a substantial number of wounds that were infected.

Background: Both benign and malignant diseases now have more and more justifications for laparoscopic splenectomy, which is currently considered a standard technique for handling practically all disorders necessitating splenectomy. Objective: We aimed to contrast the consequences of benign versus malignant hematological diseases following laparoscopic splenectomy. Patients and Methods: We carried out seventy-six laparoscopic splenectomies between 2019 and 2022. 38 patients were handled with the use of a unique method, an anterior approach, but 38 patients have been positioned in a semi-lateral position for laparoscopic intervention. Result: Malignant disorder patients had older ages (60.1), whereas benign disorder sufferers had younger ages (35.6), P = 0.001. Laparoscopy was used in 72 of 76 cases (94.7%). Four situations (5.2%) have been modified to open cases. Operative time used to be 2.51 h/min for malignant in distinction to 2.30 h/min for benign tumors (P > 0.05). Conclusions: laparoscopic splenectomy is logically appropriate as a less invasive technique for benign splenomegaly, hematological tumors, or both.