Diabetes mellitus with resistance to insulin administered subcutaneously or intramuscularly (DRIASM) is a rare syndrome and is usually treated with continuous intravenous insulin infusion. We present here two cases of DRIASM in 16 and 18 years female patients that were submitted to pancreas transplantation alone (PTA). Both were diagnosed with type 1 diabetes as young children and had labile glycemic control with recurrent episodes of diabetic ketoacidosis. They had prolonged periods of hospitalization and complications related to their central venous access. Exocrine and endocrine drainages were in the bladder and systemic, respectively. Both presented immediate graft function. In patient 1, enteric conversion was necessary due to reflux pancreatitis. Patient 2 developed mild postoperative hyperglycemia in spite of having normal pancreas allograft biopsy and that was attributed to her immunosuppressive regimen. Patient 1 died 9 months after PTA from septic shock related to pneumonia. In 8 months of follow-up, Patient 2 presented optimal glycemic control without the use of antidiabetic agents. In conclusion, PTA may be an alternative treatment for DRIASM patients.

Background: Gallbladder (GB) retrieval is essential to reduce postoperative pain after laparoscopic cholecystectomy (LC). Limited data are available for the use of endobags for GB extraction. Aims and Objectives: The study aims to assess the incidence of postoperative infection after GB extraction. Materials and Methods: The randomized prospective study was conducted in the Department of General Surgery, Government Rajaji Hospital, for 6 months. After the ethical approval, 100 patients who underwent elective LC were enrolled in the study. Patients who underwent LC and removed the GB using an endobag were included in Group A. The patients in whom the bladder was removed without using an endobag were included in Group B. Results: The study reports a female predominance, 76% in Group A and 70% in Group B. A significant difference was reported between the port-site spill in Group B patients who underwent conventional treatment without endobags and reported spillage in six patients (12.0%). In addition, port-site infection was also prevalent in four patients under Group B with a significant difference, respectively. The mean operating time was higher in Group A patients with 88.24±7.4 (hours) compared with Group B with 85.3±6.6 (hours); however, no significant difference was reported between operating time and hospital stay. Conclusion: The use of endobags in GB extraction has been reported beneficial with a lower incidence of port-site spillage and infection. This signifies the essential benefit of endobags for GB extraction with a lower incidence of postoperative complications.