Background Cholecystectomy is one of the most commonly performed surgical procedures. However, it may result in some unpleasant conditions such as bile duct injury (BDI), bile leak, and vessel injury. Subtotal cholecystectomy (SC), which has been introduced as an alternative method for reducing the complication rates, has been reported to have lower risk of BDI when compared to total cholecystectomy. This study aimed to evaluate the indications for SC, its early and late complications and their management, and the risk factors affecting the bile leak. Methods Fifty‐seven patients who underwent SC were included in the study, and their medical records were retrospectively reviewed. Results Thirty‐three patients were male (57.9%) and the mean age was 64.84 ± 11.35 (range: 29‐86). All patients had at least one episode of cholecystitis. Forty‐seven (82.5%) patients underwent surgery under emergency conditions. Postoperative bile leak/fistula, surgical site infection, and fluid collection were developed in 12 (21.1%), eight (14%), and six (10.5%) patients, respectively. Leaving the remnant tissue pouch open, presence of comorbidity and emergency operative condition were found to increase the risk of leak development (P < .001). During the average follow‐up of 49 months (range: 13‐98), symptomatic choledocholithiasis, symptomatic gallstones in the remnant tissue, and incisional hernia were detected within the first year of surgery in three (5.3%), four (7%), and seven (12.3%) patients, respectively. Conclusions Although SC is not an equivalent to total cholecystectomy, its vital benefit of lowering the risk of BDI should be considered in difficult cases.

I ncisional hernia (IH) is a common complication after open abdominal surgery and its incidence varies between 2-20% depending on the patient's age, obesity, comorbidity and type of the surgery. [1, 2] Incision type, closure of the incision and the suture material are the important factors for preventing hernia development. Incisional hernias are usually asymptomatic but may cause serious complications, such as abdominal pain, skin deformity, intestinal obstruction, strangulation, incarceration and enterocutaneous fistula. [3] Surgical intervention is indicated to prevent these complications and the expansion of the defect. Surgical options include primary repair with suture and open or laparoscopic repair with mesh. In mesh repair, onlay, sublay and inlay repairs can be applied according to the area where the mesh will be laid. [4] All three techniques are widely used, and there is no definite consensus on which technique is superior. The aim should be to apply the best Objectives: The selection of incision type, closure type of incision and the suture material are some of the important factors to prevent hernia development. We should aim to perform the best procedure with the best technique to reduce the risk of recurrence. Surgical options include primary repair and open or laparoscopic repair with mesh. Mesh repairs can be performed as onlay, sublay or inlay according to the area where the mesh is to be laid. In this retrospective study, our main goal was to compare the recurrence rates in patients who underwent incisional hernia repair with onlay and inlay mesh techniques. Methods: This retrospective study included 185 patients who underwent surgery due to incisional hernia in our clinic between January 2012 and October 2017. Patients were divided into two groups according to the technique as Group 1 with onlay mesh repair and Group 2 with inlay mesh repair. The same type of mesh (prolen) was applied to all patients. Results: There were 121 patients in Group 1 and 64 patients in Group 2. According to data we obtained, 64.3% of the patients were women and the mean age of all patients was 58.4±16.4 years. Postoperative complications (such as seroma-hematoma, surgical site infection, mesh rejection, postoperative ileus) developed in 29.2% (n=54) of the patients. The length of hospital stay was 4.2±3 days in Group 1 and 5.6±5 days in Group 2. The mean follow-up period was 48.6 months (24-93 months), with the recurrence rates of 5.8% (n=7) in Group 1 and 10.9% (n=7) in Group 2, respectively. There was a statistically significant difference between the groups concerning comorbidity, postoperative complications, the length of hospitalization stay and recurrence. Conclusion: We believe that the onlay technique will be more appropriate than the inlay technique when only prolen mesh is preferred because the recurrence rates are higher in the inlay technique.

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Management of hepatic artery trauma during hepatopancreato-biliary procedures: Evolving approaches, clinical outcomes, and literature review studies conducted, there is a common belief that more HA injuries occur in patients with anomalies. [3][4][5] In autopsy studies, it has been stated that deaths seen as a result of HA injury are mostly due to liver necrosis. Necrosis that occurs in the liver is diffuse or patchy. [1,3] Although significant improvements in complications and mortality rates due to HA injuries have been detected in recent years, it still continues to cause serious morbidity and mortality. [3,6] Better results are obtained today with a better understanding of liver physiology, antibiotics, early diagnosis, interventional procedures, and improved intensive care conditions.