No abstract

Background: Laparoscopic appendectomy is a safe and effective procedure for acute appendicitis. But several researchers found that performing laparoscopic appendectomy for complicated appendicitis may carry a risk of postoperative intraabdominal abscess development, and that's why some surgeons use the intraabdominal drain. In our study we aimed to assess the effect of the drain in laparoscopic appendectomy for complicated appendicitis. Methodology: This is a prospective comparative study which was performed at Ain Shams University Hospitals between September 2018 and September 2021. It included 80 patients who underwent laparoscopic appendectomy for complicated appendicitis. The patients were divided sequentially into two groups, Group A: drain group and Group B: no-drain group. Results: We had a non-significant difference between group A and B regarding postoperative complication (37.5% versus 32.5% respectively) and postoperative intraabdominal abscess formation (15% versus 12.5%) respectively). The no-drain group showed significantly shorter hospital stay than the drain group. We had no mortality in our study. Conclusion:In our study, we didn't find considerable benefits for using the drain over intraperitoneal irrigation and lavage without drain after laparoscopic appendectomy for complicated appendicitis with significant longer hospital stay in the drain group.

Background: Different component separation (CS) techniques had been evaluated to manage the large ventral abdominal hernias (VAH) with a debate about the best one in these hernias. We aimed to compare the outcomes of transversus abdominis release (TAR) and anterior component separation (ACS) as regard short term postoperative complication and recurrence rate. Methodology: A prospective comparative study was conducted at Ain Shams university hospitals between January 2017 and May 2021 including 80 cases of VAH with single defect 10 cm. The cases were divided into 2 groups; group (I) underwent ACS and group (II) underwent TAR. Results: A significantly higher intraoperative failure rate was seen in the ACS group (20% versus 2.5%). TAR showed significantly lower rates of early postoperative wound complications (65% versus 22.5%) and recurrence (22.5% versus 2.5%) after 1 year. Conclusion: TAR is a more effective technique in treatment of large VAH than ACS, with fewer postoperative complication and lower short-term recurrence.

Background: Duodenal perforation is an uncommon complication of endoscopic retrograde cholangiopancreatography (ERCP). Most cases are minor perforations that can be managed with conservative management. A few cases may result in life-threatening retroperitoneal collection and necrosis requiring surgical intervention. There is a relative paucity of references specifically describing the surgical interventions required for this eventuality.Methods: Ten cases of post-ERCP duodenal perforation were referred to our department at Ain Shams university Hospital between 2015 and 2019. Clinical features of our cases were analyzed, and the management plan was tailored to each case after discussion in multidisciplinary team (MDT) and review of the latest available literatures.Results: Seven patients recovered with conservative management. Three patients needed surgical intervention. All patients were successfully discharged home. There were no mortalities.Conclusions: Post-ERCP duodenal perforation is an uncommon complication of endoscopy, but when it does occur, it is potentially life-threatening. Early diagnosis may lead to a better outcome through early intervention. Most cases need only conservative treatment. A variety of surgical techniques may need to be employed according to the individual circumstances of the case.