Background The incidence of gallstone increases with increasing age. No studies have been reported in the elderly population with laparoscopic cholecystectomy from developing nations. The aim of this study was to compare perioperative outcomes of laparoscopic cholecystectomy between the elderly (≥60 years old) and the young (<60 years old). Methods From July 2015 to June 2016, a retrospective review of medical records of 78 elderly patients (≥60 years old) and 164 young patients (<60 years old) who underwent laparoscopic cholecystectomy was done. The patients' demographics and perioperative outcomes were analyzed. Results Median ages were 65 years (range: 60–80) and 45 years (range: 21–59) for the elderly group and the young group. The majority of patients were female (62.8 and 72%). There were no significant differences in the conversion rate (9 and 7.9%, P = 0.78), postoperative complications (17.9 and 14.6%, P = 0.50), and length of stay in the hospital (4 days for both groups, P = 0.35) between the two groups. There was no mortality in either of the groups. Conclusion Our results of laparoscopic cholecystectomy in elderly patients are comparable with those in young patients. Therefore, laparoscopic cholecystectomy is safe even in the elderly population.

Background: Gallbladder cancer is the most common biliary tract cancer. Incidence rate of gall bladder cancer varies worldwide.  Most of the patient with gall bladder cancer remained asymptomatic until late. Preoperative early diagnosis of carcinoma of gallbladder is rare, occurring in fewer than 20% of patients. Role of routine histopathology for cholecystectomy specimen is debatable. Aim of this study is to find the incidence of incidental gall bladder cancer and determine whether routine histopathology of cholecystectomy specimen is required or not. Methods: This is a retrospective descriptive study carried out in Universal College of Medical Sciences, Bhairahawha, Nepal. Histopathology reports of all patients who had undergone cholecystectomies from June 2014 to September 2018 were reviewed. Patients’ information regarding inpatient number, age, sex, year of diagnosis, preoperative diagnosis, intraoperative findings, histopathology report and pathological staging were recorded. Data were entered and analyzed using Microsoft Excel version 14. Results: Total of 418 routine cholecystectomies were performed during this period. Seven cases of incidental gall bladder cancer were diagnosed. None of the patients had preoperative suspicion for malignancy. One patient had intraoperative suspicion of lesion. Conclusions: Incidence of incidental gallbladder cancer is 1.67%. It is recommended that routine histopathology of cholecystectomy specimen should be sent for early diagnosis and improve survival of patient with gall bladder cancer. Keywords: Cholecystectomy; gall bladder cancer; incidence, routine histopathology

Introduction: Colonic volvulus is not an uncommon cause of large bowel obstruction. Limited research has been done about colonic volvulus in our part of the world which has been regarded as "volvulus belt." The aim of this study is to evaluate the clinical features, management, and factors affecting perioperative outcomes in patients with colonic volvulus.Methods: A retrospective review of medical records of all patients managed for colonic volvulus in Universal College of Medical Sciences, Bhairahawa from January 2012 to December 2016 was done. Data on patient demographics, clinical course, methods of treatment, and outcomes were analyzed.Results: A total of 62 patients (46 males) were studied. Mean age was 57.9 ± 10.4 years. The most common site involved was sigmoid (85.5%). The diagnosis was made by abdominal x-rays in 39 patients (62.2%), CT scan in 13 patients (21%), and laparotomy in 10 patients (16.1%). Fifty-eight patients (93.5%) were treated surgically. Resection and ostomy was the commonest operation performed in 30 patients (48.7%) followed by resection with anastomosis in 24 patients (38.7%). The overall complication was 38.7%. There were 9.7% of deaths. In multivariate analysis, age ( ≥ 60 years) (odds ratio (OR); 27.0, confidence interval (CI); (1.92-403), P; 0.01), preoperative hypotension (systolic blood pressure <90 mmHg) (OR; 7.82, CI; (1.19-51.2), P; 0.03), and gangrenous bowel (OR; 76.7, CI (3.60-1632), P; 0.005) were significant predictors of postoperative complications .Conclusions: Volvulus of the colon is common in males and constipation is being commonest risk factors for volvulus. Surgeons should have a high index of suspicion and should be aware of these problems to make the early diagnosis with prompt treatment and to ensure better patient outcomes in volvulus endemic areas like ours.

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