New trends and perspectives in hepatobiliary surgery: preface

Objective: To evaluate the procedure of radical cholecystectomy for incidental gallbladder carcinoma diagnosed after cholecystectomy at a tertiary care teaching hospital of Pakistan. Study Design: Observational study (case series). Place and Duration of Study: Army Liver Transplant Unit, Pak Emirates Military Hospital, Rawalpindi, from Jun2018 to Apr 2019. Methodology: A prospective study was conducted on 11 patients who underwent routine cholecystectomy either open or laparoscopic for a possibly benign condition but were found with a malignancy on histopathology, were included in the study. Detailed assessment regarding all the side effects was done immediately after the procedure, at 48 hours, at time of discharge and two weeks after the procedure was done on all the participants. Results: Out of 11patients included in the final analysis, 06 were male and 05 were female. Mean age of patients put who underwent cholecystectomy and had incidental finding of cancer was 44.23 ± 3.621. Mean duration of hospital stay after the surgery was 5.13 ± 2.175. Most of the patients had well differentiated tumor. Post-operative pain was the commonest complication among the target population followed by biliary complication. Cholecystectomy,Conclusion: Gallbladder carcinoma may be missed on routine clinical screening and radiological modalities.Surgeon should be careful enough and suspect unusual finding of malignancy in routine surgeries. Radicalsurgery of the incidental gallbladder cancer emerged as an effective management modality among the patientsmanaged in our set up during this study period.

Section: Discussionmentioning

confidence: 99%

Evaluation of Radical Cholecystectomy for Incidental Gallbladder Carcinoma Diagnosed After Cholecystectomy, Single Center Experience

Safdar

Wattoo

Butt

et al. 2021

“…Endoscopic method of perianal surgeries has replaced open methods in many surgical centres of the world but still, there are many indications in which open methods are preferred and still in practice. 1,2 Epidemiological data across the globe suggests that patients with pilonidal sinuses have been commonly encountered by surgeons all around the world. 3 Few centres may have trained perineal surgeons, but general surgeons have dealt with this condition in most developing countries.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Outcome after Open Pilonidal Sinus Treatment Versus Endoscopic Pilonidal Sinus Treatment (EPSIT)

Kamal,

Khurram Sarfaraz,

Faheem Ullah Naz

et al. 2023

Objective: To compare the complications among open pilonidal sinus treatment versus endoscopic pilonidal sinus treatment (EPSIT). Study Design: Comparative Cross-sectional Study. Place and Duration of Study: Department of Surgery, Combined Military Hospital, Rawalpindi Pakistan, form Feb to Nov 2021. Methodology: The study was conducted on 150 patients who underwent pilonidal sinus treatment at our surgical unit. Patients were randomly divided into two groups. Group-A underwent open pilonidal sinus surgery, while Group-B underwent endoscopic pilonidal sinus treatment (EPSIT). Recurrence, bleeding, seroma formation and occurrence of wound infection were compared in both groups. Results: All of the 150 patients included in the final analysis were males. The mean age of patients who underwent surgery for pilonidal sinus in our study was 41.22±9.34 years. 79(43%) patients underwent the open surgical method, while 71(57%) underwent the endoscopic one. All the complications were found statistically significant (p-value<0.05) in patients who underwent open surgical procedures for pilonidal sinuses compared to those who underwent endoscopic surgical methods. Conclusion: Endoscopic pilonidal surgery emerged as a better option than open pilonidal surgery. Patients undergoing open pilonidal surgery were more at risk of bleeding, recurrence, developing seroma and wound infections.

“…Abdominal surgeries have been revolutionized in last two decades across the globe. 1 Minimaaly invasive procedures have replaced a lot of traditional surgical methods but still role of these open methods have not become obsolete. 2 Laparoscopic cholecystectomy have replaced open cholecystectomy in many surgical centers of the world but still a lot of surgeons practice open method for surgical pathologies of gall bladder due to various personal, service related or patient related reasons.…”

Section: Introductionmentioning

confidence: 99%

Factors Leading to Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy

Zubair

Nasir

Malik

et al. 2022

Objective: To evaluate the various factors leading to conversion of laparoscopic cholecystectomy to open cholecystectomy. Study Design: Comparative cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from May 2020 to Sep 2021. Methodology: This study was conducted on 200 patients who underwent laparoscopic cholecystectomy for any benign pathology during the study period. Data was collected for all the patients who required conversion of surgical procedure from laparoscopic to open cholecystectomy. Demographic and clinical risk factors were associated with conversion of procedure in the study participants. Results: Out of 200 patients included in the final analysis 67 (33.5%) were male and 133 (66.5%) were female. Mean age of patients put who underwent laparoscopic surgery for benign gall bladder pathologies in our study was 43.46 ± 8.337 years. Gall stones were the commonest clinical condition for which laparoscopic cholecystectomy was done. Out of 26 (13%) patients underwent conversion of laparoscopic to open surgery. It was revealed that frozen Calots triangle (p-value-0.033), empyema gall bladder (p-value-0.018) and previous abdominal surgeries (p-value-0.013) were significantly related to conversion of laparoscopic to open surgery Conclusion: Conversion rate of laparoscopic to open surgery for cholecystectomy was high in our study population. Patients who had previous abdominal surgeries or presence of frozen Calots triangle and empyema gall bladder were more at risk of conversion of surgery.