Preoperative diagnosis of MS is difficult, but it is essential in the proper management of the disease. Investigations as magnetic cholangiography resonance and endoscopic retrograde cholangiopancreatogram contribute to the success of preoperative identification. LC should be reserved to MS type I and type II highly selected cases. This pathology should be treated by experienced surgeons to decrease the risk of iatrogenia.

Background: Gastrografin represents a useful tool in the diagnosis and management of adhesive small bowel obstruction (ASBO). The aim of this study is to identify variables with negative influence in nonoperative management with gastrografin. Methods: From August 2008 to March 2013, 223 consecutive patients with 235 episodes of ASBO were included and received gastrografin. A protocol for prospective data collection was developed. In order to explore factors related to the failure of nonoperative treatment, univariate and multivariate analysis were performed. Results: One hundred and ninety eight episodes responded to nonoperative treatment (84.2% of success) and 33 patients (15.8%) required surgical intervention. Only 3 patients of the gastrografin cohort with contrast in colon, required surgery. Predictive factors of failure of nonoperative management with gastrografin were patients aged above 65 (p = 0.01; OR 1.791, 95% CI 1.41-2.19), with a history of 2 or more previous laparotomies (p = 0.03; OR 2.91, 95% CI 2.19-3.71), and who had undergone previous abdominal surgery due to ASBO (p = 0.002; OR 1.381, 95% CI 1.10-1.79). Conclusion: Patient age, the number of previous laparotomies, and the fact that previous abdominal surgery was conducted due to ASBO are indicative of unsuccessful management with gastrografin.

Purpose Long‐term extension of a previous randomized controlled clinical trial comparing open (OVHR) vs. laparoscopic (LVHR) ventral hernia repair, assessing recurrence, reoperation, mesh‐related complications and self‐reported quality of life with 10 years of follow‐up. Methods Eighty‐five patients were followed up to assess recurrence (main endpoint), reoperation, mesh complications and death, from the date of index until recurrence, death or study completion, whichever was first. Recurrence, reoperation rates and death were estimated by intention to treat. Mesh‐related complications were only assessed in the LVHR group, excluding conversions (intraperitoneal onlay; n = 40). Quality of life, using the European Hernia Society Quality of Life score, was assessed in surviving non‐reoperated patients (n = 47). Results The incidence rates with 10 person‐years of follow‐up were 21.01% (CI 13.24–33.36) for recurrence, 11.92% (CI: 6.60–21.53) for reoperation and 24.88% (CI 16.81–36.82) for death. Sixty‐two percent of recurrences occurred within the first 2 years of follow‐up. No significant differences between arms were found in any of the outcomes analyzed. Incidence rate of intraperitoneal mesh complications with 10 person‐years of follow‐up was 6.15% (CI 1.99–19.09). The mean EuraHS‐QoL score with 13.8 years of mean follow‐up for living non‐reoperated patients was 6.63 (CI 4.50–8.78) over 90 possible points with no significant differences between arms. Conclusion In incisional ventral hernias with wall defects up to 15 cm wide, laparoscopic repair seems to be as safe and effective as open techniques, with no long‐term differences in recurrence and reoperation rates or global quality of life, although lack of statistical power does not allow definitive conclusions on equivalence between alternatives. Trial registration number ClinicalTrial.gov (NCT04192838).