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Purpose: Cholecystitis presents significant treatment challenges, especially in elderly patients with high surgical or anesthetic risks. While cholecystectomy remains the standard intervention, its feasibility is sometimes limited, leading to reliance on cholecystostomy, which has a high recurrence rate and does not address the underlying cause. The aim was to evaluate the efficacy and safety of chemical gallbladder ablation as a minimally invasive treatment option for acute cholecystitis in elderly and comorbid patients. Materials and methods: This retrospective study included patients admitted for chemical gallbladder ablation from 2014 to 2024, contraindicated for cholecystectomy/anesthesia. Procedures involved ultrasound-guided drainage, cholangiography, potential cystic duct embolization, and ethanol ablation. Outcomes measured included complications, recurrence rates, gallbladder atrophy rates, and hospital stay duration. Results: Of 24 patients considered, 20 underwent chemical ablation with no reported complications or ethanol intoxication, with one recurrence of cholecystitis. 9 patients underwent cystic duct embolization prior to chemical ablation. The median hospital stay duration and post-procedure overall survival was 20 and 603 days, respectively. Among the 13 patients who received follow-up imaging, gallbladder atrophy was achieved in 5 of the 6 patients who had cystic duct embolization prior to chemical ablation, and 2 of the 7 patients who had not cystic duct embolization. Conclusion: This series suggests that chemical gallbladder ablation with cystic duct embolization could be a viable, safe and minimally invasive option for managing acute cholecystitis in elderly, multimorbid patients. Further research is necessary to validate these findings. [ABSTRACT FROM AUTHOR]

Transverse and midline abdominal incisions are both commonly used for laparotomy to perform surgery on the pancreas and stomach, but comparative data are limited, especially from prospective randomized trials. During a predefined 2-year recruitment period, 94 patients undergoing an elective major laparotomy for disorders of the pancreas or stomach were enrolled in this study. The outcome measures were pulmonary function, incisional pain, and wound characteristics. The operation groups were equally divided according to the type of incision used. The patients who underwent transverse incision laparotomy had significantly better postoperative pulmonary function and significantly less postoperative incisional pain than those who underwent midline incision laparotomy ( P < 0.05), but there were no differences in morbidity and the incidence of wound complications. Performing a transverse incision for surgery on the pancreas or stomach results in better postoperative pulmonary function and less incisional pain than a midline incision, without affecting postoperative morbidity. [ABSTRACT FROM AUTHOR]