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PurposeExtremely elderly patients who present with complicated gallstone disease are less likely to undergo definitive treatment. The use of laparoscopic cholecystectomy (LC) in older patients is complicated by comorbid conditions that are concomitant with advanced age and may increase postoperative complications and the frequency of conversion to open surgery. We aimed to evaluate the results of LC in patients (older than 80 years).MethodsWe retrospectively analyzed 302 patients who underwent LC for acute cholecystitis between January 2011 and December 2013. Total patients were divided into three groups: group 1 patients were younger than 65 years, group 2 patients were between 65 and 79 years, and group 3 patients were older than 80 years. Patient characteristics were compared between the different groups.ResultsThe conversion rate was significantly higher in group 3 compared to that in the other groups. Hematoma in gallbladder fossa and intraoperative bleeding were higher in group 3, the difference was not significant. Wound infection was not different between the three groups. Operating time and postoperative hospital stay were significantly higher in group 3 compared to those in the other groups. There was no reported bile leakage and operative mortality. Preoperative percutaneous transhepatic gallbladder drainage and endoscopic retrograde cholangiopancreatography were performed more frequently in group 3 than in the other groups.ConclusionLC is safe and feasible. It should be the gold-standard approach for extremely elderly patients with acute cholecystitis.

Nanoparticles, the elementary structures of nanotechnology, are important materials for fundamental studies and variety of applications. The different sizes and shapes of these materials exhibit unique physical and chemical properties than their bulk materials. There is a great interest in obtaining well-dispersed, ultrafine, and uniform nanoparticles to delineate and utilize their distinct properties. Nanoparticle synthesis can be achieved through a wide range of materials utilizing a number of methods including physical, chemical, and biological processes with various precursors from liquids and solids. There is a growing need to prepare environmentally friendly nanoparticles that do not produce toxic wastes in their process synthesis protocol. This kind of synthesis can be achieved by green environment benign processes, which happen to be mostly of a biological nature. Microorganisms are one of the most attractive and simple sources for the synthesis of different types of nanoparticles. This review is an attempt to provide the up-to-date information on current status of nanoparticle synthesis by different types of microorganisms such as fungi, yeast, bacteria, cyanobacteria, actinomycete, and algae. The probable biosynthesis mechanism and conditions for size/shape control are described. Various applications of microbially synthesized nanoparticles are summarized. They include antibacterial, antifungal, anticancer, larvicidal, medical imaging, biosensor, and catalytic applications. Finally, limitations and future prospects for specific research are discussed.

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