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Introduction: Laparoscopic cholecystectomy (LC) is the gold standard for patients with acute cholecystitis at early period. However, 15%-20% of patients with acute cholecystitis develop obstructive jaundice, cholangitis and bile duct stones ultimately requiring endoscopic retrograde cholangiopancreatography (ERCP). In such cases, a two-session approach is usually recommended, first ERCP followed by LC thereafter. However, the effect of prior ERCP on the difficulty of subsequent LC is unknown. Hence, the aim of the present study is to determine the effects of previous ERCP on the results of LC., Patients and Methods: In this study, the files of 1500 patients who underwent LC were reviewed retrospectively. The patients were divided into three groups (500 patients for each group). The patients undergoing LC for asymptomatic cholelithiasis were assigned to the L-e group. The patients who underwent LC for acute cholecystitis were assigned to the L-c group. The patients with acute cholecystitis who underwent ERCP first and then LC were assigned to the L-ercp group. The rates of conversion to open cholecystectomy, operation times, complication rates and hospital stays of the three groups were compared., Results: The results of LC performed after ERCP are similar to the results of LC for cholecystitis without ERCP in terms of operation time, hospital stay, conversion and complications., Conclusions: Previous ERCP does not affect the safety and effectiveness of early LC in patients with acute cholecystitis., (Copyright © 2024 Copyright: © 2024 Journal of Minimal Access Surgery.)

Objective: This study presents the effects of intraoperative nerve monitoring on RLN injuries in patients who underwent primary surgery for benign thyroid pathology., Methods: We retrospectively evaluated the data of 273 patients who had primary thyroidectomy due to benign thyroid pathology between January 2012 and July 2017. The patients were classified into two groups. Group-1 consists of patients whose nerves were monitored. We separated the patients whose nerves were not monitored into Group-2., Results: There were 140 and 133 patients in Groups 1 and 2, respectively. Regarding the age, gender and surgical indication between the groups, statistically significant difference was not found (P > 0.05). In Group-1, transient paralysis developed in four patients (2.9%). The permanent paralysis developed in one patient (0.7%). In Group-2, transient paralysis developed in nine patients (6.8%). The permanent paralysis developed in four patients (3%). When the groups were evaluated, there was statistically significant difference in terms of transient and permanent paralysis (P=0.01, P =0.001, respectively)., Conclusions: In view of the negative effects of RLN injury on the patient, we think that intraoperative nerve monitoring should be used routinely in benign thyroid surgeries., (Copyright: © Pakistan Journal of Medical Sciences.)

Objective: To investigated oxidative stress changes in renal colic patients, and to determine its role in differential diagnosis of renal colic., Methods: The cross-sectional study was conducted at Ankara Atatürk Training and Research Hospital, Turkey, from June 2012 to December 2012 and comprised patients with complaints suggesting of renal colic and diagnosed with urinary stone. Healthy individuals were enrolled to form the control group. The patients and the control group were evaluated in terms of oxidative stress parameters. SPSS 17 was used for statistical analysis., Results: Of the 83 subjects, 50(60%) were patients with renal colic, while 33(40%) were healthy controls. Among the patients, 25(50%) were men and 25(50%) were women. Among the controls, there were 17(51.5%) men and 16(48.5%) women. No statistically significant difference was found between the two groups in terms of age and gender (p>0.05). Likewise, no statistically significant difference was found between the oxidative stress indexes of the two groups (p>0.05)., Conclusions: There was no significant increase in oxidative stress in patients with renal colic. The result may help in the differential diagnosis of patients with abdominal pain.

Aim: To report the results of open surgery for patients with basket impaction during endoscopic retrograde cholangiopancreatography (ERCP) procedure., Methods: Basket impaction of either classical Dormia basket or mechanical lithotripter basket with an entrapped stone occurred in six patients. These patients were immediately operated for removal of stone(s) and impacted basket. The postoperative course, length of hospital stay, diameter of the stone, complication and the surgical procedure of the patients were reported retrospectively., Results: Six patients (M/F, 0/6) were operated due to impacted basket during ERCP procedure. The mean age of the patients was 64.33 ± 14.41 years. In all cases the surgery was performed immediately after the failed ERCP procedure by making a right subcostal incision. The baskets containing the stone were removed through longitudinal choledochotomy with the stone. The choledochotomy incisions were closed by primary closure in four patients and T tube placement in two patients. All patients were also performed cholecystectomy additionally since they had cholelithiasis. In patients with T-tube placement it was removed on the 13(th) day after a normal T-tube cholangiogram. The patients remained stable at postoperative period and discharged without any complication at median 7 d., Conclusion: Open surgical procedures can be applied in patients with basket impaction during ERCP procedure in selected cases.