Introduction: controversy remains about the management of gallstone ileus. While some authors propose enterotomy, others defend the one-stage procedure (simultaneously fistula repair). The objective of the present study was to analyze management options and comparative study their results. Material and methods: retrospective and descriptive study with revision of clinical stories of patients with the diagnosis of gallstone ileus between 1987 and 2008. All the following variables were recorded: dates of hospital admission, surgery and discharge, age, sex, pathological antecedents, preoperative or intraoperative diagnosis, treatment, location of the fistula and location of the obstruction. End-result variables were: postoperative complications, mortality, complications during the follow-up and biliary complications. Results: a total of 40 patients were included of 46,648 admissions. Age, comorbidity, and intraoperative diagnosis were related with poorer short-and long-outcomes. The percentage of postoperative complications was similar for groups with and without fistula repair. Mortality was higher in the group with fistula repair (15 vs. 25%). Biliary complications were more frequent in the group without fistula repair (11 vs. 0%). Sex, location of the fistula and location of the obstruction did not be related with the prognosis. Conclusion: one-stage procedure is related with higher mortality rate than enterotomy alone. Nevertheless, fistula repair reduces the number of biliary complications during the follow-up.

Background: Intra abdominal pathologies requiring surgical intervention include appendicitis , malignancies, trauma ,perforation peritonitis etc. The most common organism isolated at the time of surgery was E. coli.We studied the spectrum of microbes at the time of laparotomy/laparoscopy to help us to know the emerging trends in microbiological spectrum and the sensitivity pattern in this medical college hospital. Objective: To study the microbial spectrum and sensitivity pattern in patients with intra abdominal pathology requiring surgical interventions. Methodology: After ethical committee approval was obtained, data for this retrospective study, with a sample size of 93 cases were collected from theGeneral Surgery Records and analysed. Result: Of the 93 cases studied, E. coli dominated in 75% cases of acute appendicitis and Enterococcus was found in 16.2%. In cases of hollow viscous perforation 50% were E.coli and 15.3% were K.pneumoniae. In acute appendicitis with peritonitis 64.25% were E.coli, K.pneumoniae and Enterococcus were 21.4% each.In case of colonic malignancy 28.5% of patients were infected by E. coli followed by enterococcus with 21.4%. E.coli and K. pneumoniae were more sensitive to carbapenems, colistin and fluroquinolones, while Enterococcus was more sensitive to Linezolid. Conclusion: E. coli is the organism that predominates in intra abdominal pathology requiringsurgical intervention and the common organisms are mostly sensitive to the carbapenems, linezolid , Colistin and fluroquinolones.

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OBJECTIVE:To study about additional risks associated with thyroid surgery in the elderly population. DESIGN: Retrospective analysis of a prospective documented data in consecutive patients undergoing thyroid surgery from January 2012 to June 2014 in a tertiary care health center. PATIENTS: The study included patients aged 30 to 40 years as control group and patients of 60 years and above who underwent thyroidectomy. MAIN OUTCOME MEASURES: Pathology reports, complications (including rates of temporary and permanent hypocalcemia and stridor, seroma/hematoma, and duration of hospital stay. RESULTS: There were 68 patients of 30-40 age group who under-went thyroidectomy between January 2012 and June of 2014; 46 elderly patients underwent surgery during that same time frame. There were no deaths in both cohort, and no cases of permanent TVF paralysis. The elderly patients had a similar rate of complications when compared with the younger patients, (60% vs 70%) but a higher duration of hospital stay (6.9 vs 5.4). CONCLUSIONS: Thyroid surgeons will be faced more often with the prospect of elective thyroid surgery in patients of advanced age, as an increasingly aged population emerges and the prevalence of thyroid nodules and thyroid cancer increases. Thyroid surgery in optimized elderly patients is safe and no more dangerous, than surgery in younger patients though the duration of hospital stay is more.

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