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Laparoscopic cholecystectomy (LC) has now become the “gold standard” treatment for symptomatic gallstone disease. Thanks to its advantages (i.e., smaller scars, reduced postoperative pain), patients enjoyed a shorter hospital stay and consequently, many healthcare providers have started to explore the feasibility of offering LC as a day-case procedure, and in 1990 some authors had already reported the first experiences of ambulatory surgery. Nowadays day-case LC (DLC) has been adopted with different rates and it is not fully accepted by all surgeons. The main question concerns whether the DLC might be feasible for all or just for selected cases. It is common opinion that DLC is indicated for selected cases and the selection may concern medical and logistic criteria. Some exclusion criteria may be considered advisable: common bile duct stones, acute cholecystitis, pancreatitis, patient’s age, and intraoperative complications. Some authors pointed out the importance of anesthesia and postoperative control of pain, nausea, and vomiting as strongly needed elements to allow patients’ early discharge. In conclusion DLC seems to be a safe and effective intervention in selected patients (with no or minimal systemic disease and within easy reach of the hospital) with symptomatic gallstones.

Crohn's Disease (CD) occurs in the elderly in 5 - 25% of cases. Aim of our study: to define the features of clinical presentation, diagnostic tools and therapy of CD in old age.In the last ten years we observed in our Department 47 patients affected by CD. We divided them into two groups: A (42 patients65 years old) and B (5 patients ≥ 65 years old). A retrospective survey evaluated the clinical presentation, diagnosis and treatments with relative outcomes.Group A: 23/42 patients (54,76%) were operated on. The most important indication for surgery was intestinal obstruction (15/42 pts, 65,2%). Small bowel resection was the most frequent surgical procedure (13/42 pts, 56,2%). Overall, 2/23 (8,7%) of the patients developed postoperative complications. There was no postoperative mortality. 8 pts (34,7 %) developed recrudescence of CD. Group B: 3 of 5 pts were operated on. Intestinal obstruction was the indication for surgery in all cases (100%). Two patients underwent small bowel resection (66,6%) and the third patient was submitted to an ileo-colic resection (33,3%). There was no mortality in the aftermath of surgery. In 2/3 operated patients (66,6%) recurrence occurred. All operations in the old patients were performed in urgency.Surgery of CD in the elderly appears in our experience to have the same indications and procedures as in young patients. The postoperative morbidity, mortality and recurrence rates are similar in two groups even if we observed slightly higher postoperative morbidity rates in elderly due to the presence of comorbidity.

The liver is the most common site of metastasis from colo-rectal cancer (CRC) that may already be present up to 30% of cases the diagnosis of the primary tumor. In recent years, thanks to the improvement of surgical techniques and chemotherapy, the prognosis is improved and the criteria for a correct indication for surgery are less restrictive than in the past [1][2]. The behaviour in the presence of synchronous liver metastases (ME), however, is still controversial, and removal of the primary tumor and ME can occur at different times. In view of the improvement of surgical techniques and perioperative management of technological development, in some selected cases a contemporary approach can be planned. We have thus decided to conduct a retrospective study to evaluate whether there is increased risk of morbidity 'and mortality, as well as a significant increase in operative time, especially focusing on the influence of age in the simultaneous treatment of the primary tumor and ME.