BACKGROUNDGallstone spillage during laparoscopic cholecystectomy is not uncommon and despite all precautions and adoption of safety measures spilt gallstone remain unretrieved. We are trying to document the incidence of spilt gallstones during laparoscopic cholecystectomy, the cause and consequences of such spillage, probable measure to be adopted to prevent gallstone spillage during laparoscopic cholecystectomy and to take care to retrieve all spilt stones. MATERIALS AND METHODSThe study included 150 consecutive laparoscopic cholecystectomy pardoned between October 2014 and November 2015. Data were collected in a prospective manner. Detail study was conducted in terms of diagnosis and consequences of spillage of gallstones. Followup were performed at the end of 1 week, 1 month, 6 months and 1 year. RESULTSThe spillage of gall stones during surgery occurred in 19.04% of the cases. Majority of the spillage occurred due to perforation of the gall bladder during dissection followed by application of toothed grasper. Although, all visible spilt stones were retrieved during surgery, complication rate of 0.66% was observed. CONCLUSIONThe incidence and complications secondary to the spillage of gall stones during standard laparoscopic cholecystectomy is low, but avoidable; various complications can occur over a large period of time. Thus, it is advisable to retrieve as many gallstones as possible, short of converting to a laparotomy.

This review discusses anatomical facts that are of relevance to the performance of a safe cholecystectomy. Misinterpretation and Illusion of normal anatomy and anatomical variation contribute to the occurrence of major postoperative complications like biliary injuries following a cholecystectomy, the incidence being higher with lap chole. A look at the basic anatomy is therefore important for biliary and minimally invasive surgeons. This includes normal anatomy and variations of the biliary apparatus as well as arterial supply to the gallbladder. Specific anatomical distortion due to the laparoscopic technique, their contribution in producing injury and a preventive strategy based on this understanding are discussed. Investigative modalities that may help in assessing anatomy are considered. Newer insights into the role of anatomic illusions as well as the role of a system based approach to preventing injuries is also discussed.

BACKGROUND Corpus callosum is the main commissural tract between the two halves of the brain and assumes an essential job in transferring sensory, motor, and cognitive data from identical regions in the two brain hemispheres. Literature on the issue of the human corpus callosum sexual dimorphism is not universal. Similarly, age related change in corpus callosum measurements is also not consistent. METHODS Different diameters of brain and corpus callosum like longitudinal and vertical diameters of brain and length, height, widths of corpus callosum etc. were measured with digital vernier caliper. RESULTS 37 brains were collected, out of which 24 were male & 13 were female brains of various ages between 20 years and 70 years of age. Average longitudinal & vertical diameters of brain specimens under study were 158.29 mm and 102.41 mm respectively and average length of corpus callosum was 72.19 mm. Change in length of corpus callosum in relation to gender is not significant with p value >0.05. There is decrease in length of corpus callosum after 65 years of age. CONCLUSIONS Positive linear correlation was observed between length of corpus callosum and the length & vertical diameters of brain. The study has failed to establish statistically significant gender differentiation in the diameters of corpus callosum. Also, there was decrease in the length of corpus callosum (EZ) in 65 years and above age group with decrease in height and width of body as well as splenium of corpus callosum between 50-60 years age group.

No abstract

No abstract