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Background and aim and objectives T-tube choledochostomy is performed following open or laparoscopic common bile duct exploration. There is increased concern regarding safety and efficiency of choledochostomy. The present paper evaluates the short-lived effectiveness and safety of T-tube bile leak after its removal. Patients and methods A total of 86 cases of choledocholithiasis were admitted to Al-Azhar University Hospital, Assiut. They underwent cholecystectomy (open), choledochotomy, and T-tube choledochostomy. T-tube choledochography was performed 10 days after surgery, and removal of the tube was done after 12 days. Results Morbidities, mainly bile leak and peritonitis, were estimated. A total of 10 patients had evidence of radiological leak. Marked biliary reactions were noticed in six cases promptly following T-tube removal. Five of these cases had clinical peritonitis, treated conservatively. Only one patient had biliary peritonitis and required reoperation. Conclusion The operative use of T-tube choledochostomy has been in dramatical decline in the past 20 years (owing to the development and adoption of removal lesser invasive maneuvers of choledocholithiasis removal). Manipulation of T-tube (situation and extraction) is technically exigent. Intricacy and morbidity are critical; thus, it is recommended not to be performed as a routine maneuver. Easier options must be taken into account initially.

Objectives The aim of this study is to evaluate the outcome of total thyroidectomy (TT) for the management of benign thyroid disease. Background The extent of thyroid resection in benign thyroid disease is controversial revolving around the potential risk of hypoparathyroidism and nerve injury. The potential advantage of TT is one stage removal of incidental thyroid cancer and low risk of goiter recurrence. Patients and methods This prospective study was done at Al-Azhar University Hospitals from October 2016 to April 2019. One hundred patients who underwent TT for clinically benign thyroid disease were enrolled. All patients were subjected to clinical evaluation, neck ultrasonography, vocal cord examinations, and investigations. Follow-up was done for all patients for 6 months. Results Of the 100 patients who were included in the study, 27 have Graves’ disease versus 73 have non-Graves’ disease, the age group range from 35 to 65 years old. The rate of transient hypocalcemia and temporary recurrent laryngeal nerve palsy was 25.9 versus 6.8% and 3.7 versus 2.7%, respectively. One patient suffered from postthyroidectomy bleeding in Graves’ group, and incidental thyroid cancer was found in two cases. Conclusion TT for benign thyroid disease can avoid reoperation for incidental thyroid cancer, recurrent nodular goiter, recurrent toxic goiter, and can eliminate any subsequent risk of malignant change in the residual thyroid gland.

Background Inguinal hernia occurs in ∼1.5% of the general population and in 5% of male individuals. The bilateral type affects about 12% of patients, the direct and the combined ones being more frequent than the indirect. Simultaneous or sequential repair has been debated especially after tension-free repairs. Aim This study was carried out to compare Stoppa procedure with bilateral Lichtenstein hernioplasty for the treatment of primary bilateral inguinal hernia. Patients and methods This trial included 80 male patients with primary bilateral inguinal hernias. They were divided randomly into two equal groups. Group A underwent bilateral Lichtenstein hernioplasty and group B underwent Stoppa repair. Preoperative, operative, and postoperative characteristics were recorded for each patient in the study. Patients were followed up at 3, 6, and 12 months postoperatively. Results As regards preoperative data, there was no statistically significant difference between both groups. The Stoppa operation took a significantly shorter time than the bilateral Lichtenstein technique; the mean operative time for Stoppa and bilateral Lichtenstein was 84.0±8.6 and 96.4±6.2 min, respectively. Visual analogue scoring of pain 12 h postoperatively was significantly lower in the Stoppa group than in the bilateral Lichtenstein group. As regards operative and postoperative complications, there was no significant difference between both groups. Hospital stay, return to normal daily activities, and inguinodynia rates were similar in both groups. There was no recorded recurrence in both groups up to 1 year of follow-up. Conclusion Bilateral primary inguinal hernias can be operated upon in one setting without an increase in morbidity or recurrence rate. The Stoppa technique can be a good alternative to bilateral Lichtenstein procedure for the treatment of bilateral inguinal hernia, with comparable outcome.