OBJECTIVES: The aim of this prospective study was to evaluate the safety and feasibility of laparoscopic splenectomy (LS) in patients with hematological disorders of the spleen. SUBJECTS AND METHODS: Between 1999 and 2001, 15 patients (11 female and 4 male), with a mean age of 30 years, underwent LS after preoperative evaluation. If difficulties were encountered in LS, one trocar site incision was enlarged to 7-8 cm to engage the left hand for hand-assisted laparoscopic splenectomy (HALS) and the procedure was completed. Various parameters were reported, including spleen size as assessed by ultrasound scan, postoperative mortality and morbidity rates, accessory spleen removal, conversion rate, operative times and length of hospital stay. LS was successfully completed in 9 patients (60%) and HALS was performed in 4 patients (26.6%). Two patients required conversion to open splenectomy. RESULTS: The mean operative time was 209 min and the mean hospital stay was 8.1 days. The hospital stay was significantly longer among HALS patients than LS patients. The mean age of patients and splenic size were associated with a significantly higher conversion rate. No deaths were attributed to the procedure. Complications occurred in 2 of 15 patients. Accessory spleens were identified in 2 patients. CONCLUSIONS: LS is both a safe and feasible procedure, but it requires great technical care to avoid serious complications.

Adolescent↗

PubMedDate not supplied

Primary hepatic carcinoid tumor.

OBJECTIVES: To describe a rare case of primary carcinoid tumor of the liver and its management. CLINICAL PRESENTATION AND INTERVENTIONS: A 44-year-old Nigerian male presented with a big inoperable liver mass, which proved to be a carcinoid tumor by fine needle aspiration cytology. Extensive search for a primary lesion including laparotomy and peroperative ultrasound failed to find a primary lesion in the gastrointestinal tract and pancreas. Percutaneous embolization of the tumor followed by complete dearterializations of the liver seemed to have halted the growth of the tumor. The patient remained well with normal liver function tests for 56 months when he decided to go back to his country. CONCLUSION: The result showed that dearterializations of a primary inoperable carcinoid of the liver offered good palliation.

Adult↗

PubMedDate not supplied

Ruptured extrauterine gestation in heterotopic pregnancy.

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Abdomen, Acute↗