Introduction: Percutaneous Biliary drainage (PTBD) is required as palliation and optimization for surgery or chemotherapy in carcinoma gallbladder (GBC) but may be associated with complications. We aimed to study the outcomes, complications and changes in quality of life in patients with GBC undergoing PTBD.Methods: A prospective study from July 2018 to December 2019 in patients of GBC presenting with obstructive jaundice was done. Patients planned for PTBD were included in the study. The progression of disease, complications of PTBD, re-interventions, effects on initiation or completion of chemotherapy, surgical resection or intervention, overall survival was recorded. Quality of life (QoL) was assessed using SF-36 questionnaire before and after 4-6 weeks of intervention.Results: Of 160 patients assessed for inclusion, 60 (mean age: 53.7 ± 10.95 years, 27 (45 %) males) were eventually included. Eleven patients (18.3%) had metastatic disease at presentation. Of 60 patients undergoing PTBD, none had immediate procedure related complications, 41(68 %) patients had at-least one and 18 (30%) patients had more than one complication. The most common complication was pericatheter bile leak (41.6%) followed by catheter dislodgement (30 %), blockage (23.3 %) and bleeding (10 %). Re-intervention was required in 32 (53 %) of patients. There was a signi cant decrease in QoL after PTBD (P<0.0001). Median survival after PTBD was 12 weeks. Conclusion:The high technical success of PTBD does not translate into the improvement of QoL, survival, and curative surgical treatment.

Choledochal cyst and gallbladder duplication are rare congenital anomalies. They typically are surgical problems of infancy or childhood but rarely may present in adults also. Despite high resolution imaging, the differentiation of type II choledochal cyst from gallbladder duplication often causes the diagnostic dilemma; which may result in high risk for intraoperative iatrogenic injury. Operative management of choledochal cyst is the definite treatment because of its malignant potential. A type II choledochal cyst arising from the hepatic hilum presenting as gallbladder duplication on imaging has not been reported earlier in the literature and here we present a case report of the same which was managed successfully.

Introduction: Percutaneous Biliary drainage (PTBD) is required as palliation and optimization for surgery or chemotherapy in carcinoma gallbladder (GBC) but may be associated with complications. We aimed to study the outcomes, complications and changes in quality of life in patients with GBC undergoing PTBD. Methods: A prospective study from July 2018 to December 2019 in patients of GBC presenting with obstructive jaundice was done. Patients planned for PTBD were included in the study. The progression of disease, complications of PTBD, re-interventions, effects on initiation or completion of chemotherapy, surgical resection or intervention, overall survival was recorded. Quality of life (QoL) was assessed using SF–36 questionnaire before and after 4-6 weeks of intervention. Results: Of 160 patients assessed for inclusion, 60 (mean age: 53.7 ± 10.95 years, 27 (45 %) males) were eventually included. Eleven patients (18.3%) had metastatic disease at presentation. Of 60 patients undergoing PTBD, none had immediate procedure related complications, 41(68 %) patients had at-least one and 18 (30%) patients had more than one complication. The most common complication was peri-catheter bile leak (41.6%) followed by catheter dislodgement (30 %), blockage (23.3 %) and bleeding (10 %). Re-intervention was required in 32 (53 %) of patients. There was a significant decrease in QoL after PTBD (P<0.0001). Median survival after PTBD was 12 weeks.Conclusion: The high technical success of PTBD does not translate into the improvement of QoL, survival, and curative surgical treatment.

Background: Simultaneous pancreas kidney transplant (SPK) gives a physiological replacement of pancreas and kidney function in patients with end-stage renal disease (ESRD) due to type 1 diabetes mellitus (DM) after which the patients can be free from dialysis and insulin therapy. The aim of our study was to report the experience with SPK transplant at a tertiary care center in India. Methods: Outcomes were reported by retrospective review of data of patients who underwent SPK transplant at our center from January 2019 through December 2021.Results: Eleven patients underwent SPK transplant during the study period. Median age of recipients was 36. Ten patients had type 1 DM and one patient had type 2 DM. Median age of donors was 32 years. Median serum creatinine in the donors was 3.54 and amylase was 87. Kidneys were placed in left iliac fossa and pancreas in right iliac fossa. Median cold ischemia time was 561 minutes for pancreas and 417 minutes for kidneys. Median graft weight of kidneys was 142 g. Pancreatic drainage was enteric in all cases. Five patients needed re-laparotomy. Two patients needed graft pancreatectomy in view of duodenal necrosis. One patient had SMV thrombosis but graft was salvaged after re-exploration. One year graft survival was 100% for kidneys and 81% for pancreas. Median creatinine at end of 1 year was 1.01 mg/dL. All patients were independent of dialysis and insulin at end of 1 year. Conclusions: SPK transplant is an effective treatment for type 1 DM with ESRD with favorable outcomes. Though SPK transplant patients had early period complications, timely diagnosis and intervention can prevent graft loss and provide better outcomes.