Vol. 4 No. 1 (2020)

Open Access

Perspective

Article ID: 33

Standard port placement for laparoscopic pancreatic surgery: How we do it

by Jitendra H. Mistry, Sanjiv Haribhakti

General Surgery, Vol.4, No.1, 2020; 833 Views, 11 PDF Downloads

Advanced laparoscopic surgeries are technically demanding, among which laparoscopic pancreatic surgeries are the most challenging. One of the technical difficulties is the improper port placement. As there is no standard port placement for laparoscopic pancreatic surgeries, it is difficult to get proper angle to work at different steps of the surgery if ports are not well placed. It is also responsible for musculoskeletal problems to the operating surgeon. Here we propose a standard port placement for laparoscopic pancreatic surgery which gives ergonomic comfort in all laparoscopic pancreatic surgeries.

Open Access

Clinical Trial

Article ID: 34

The effects of preoperative milk drinking on gallbladder perforation during laparoscopic cholecystectomy

by Mohammad Moazeni- Bistgani

General Surgery, Vol.4, No.1, 2020; 801 Views, 6 PDF Downloads

One of the complications of laparoscopic cholecystectomy (LC) is gallbladder perforation during surgery. Fasting before surgery causes gallbladder distention, which may increase the chance of iatrogenic gallbladder perforation during LC. A fatty meal stimulates endogenous cholecystokinin release and, consequently, the gallbladder contraction. This study evaluates the effects of preoperative milk drinking on gallbladder distention and iatrogenic gallbladder perforation during LC. This study was performed on patients who were candidates for elective LC in a university hospital from March 2011 to March 2012. 260 patients were randomly divided into two equal groups. The case group drank 300 mL of cold full-fat pasteurized cow’s milk, while the control group drank 300 mL of cold water as the placebo, six hours before LC surgery. Data were collected in a questionnaire and analyzed using descriptive statistical tests, t-test, and ANOVA analysis. In the 260 patients, despite a lack of significant differences in demographic and risk factors for gallbladder perforation between the two groups, both distention and gallbladder perforation rates were significantly lower in the case group than in the control group (P = 0.001 and, P = 0.032, respectively). Thus, drinking cold full-fat pasteurized cow’s milk before LC surgery can reduce gallbladder distention and, consequently, the risk of gallbladder perforation during LC.