Preoperative CGA may predict postoperative complications and prolonged postoperative hospital stay of elderly patients who undergo elective laparoscopic cholecystectomy. Larger-scale studies independently assessing this association are warranted.

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In patients with extrahepatic lesions more than 2 cm from the papilla and with a relative poor prognosis (< or = 3 months), due to more advanced disease or to a worse general condition, the sphincter of Oddi should also be stented in order to reduce the postprocedural morbidity.

Background: Roux-en-Y reconstruction is sometimes associated with symptoms that suggest food stasis, as a result of dysmotility of either the gastric remnant and/or the efferent jejunal limb. Objective: To study the possible effect of intravenous erythromycin lactobionate on gastric emptying of solids in patients who have undergone a Roux-en-Y procedure. Patients: Twenty-four patients with a Roux-en-Y procedure participated in the study. Ten of them had undergone truncal vagotomy with pyloroplasty; the remaining 14 had undergone a Billroth II subtotal gastrectomy as the initial antiulcer procedure. Sixteen healthy subjects served as controls. Methods: All healthy subjects and patients underwent assessment of gastric emptying of a standard radiolabeled solid meal after administration of placebo or 200 mg of erythromycin lactobionate intravenously. Scanning was done with a gamma camera, and emptying curves were constructed. From these curves the half-time of gastric emptying was calculated. Results: Patients with severe symptoms of gastric stasis had a significantly longer half-time than did patients with mild or no symptoms (P = .002). Patients with a Billroth II subtotal gastrectomy as the initial antiulcer procedure had a significantly worse grade of symptoms (P = .01) and a significantly prolonged half-time (P = .02) compared with patients with a truncal vagotomy with pyloroplasty as the initial antiulcer procedure. Erythromycin significantly reduced the half-time in the controls (PϽ.001) and all patients after Roux-en-Y procedure (PϽ.001). Conclusion: Erythromycin could be a useful prokinetic drug in patients with Roux stasis syndrome.

We report a case of a 71-year old woman with right inferior epigastric artery pseudoaneurysm following laceration by a computed tomography-guided 18G biopsy needle. The laceration was initially treated with placement of retained sutures; however the patient turned hemodynamically unstable 41 days later. Percutaneous ultrasound-guided injection of 1500 U of thrombin solution resulted in almost complete thrombosis of the pseudoaneurysm; however 24 hour control ultrasound revealed refilling of the pseudoaneurysm. Definite treatment was achieved by transcatheter coil embolization. Inferior epigastric artery pseudoaneurysm with underlying laceration may not respond to percutaneous thrombin injection, whereas coil embolization is shown to be effective.