17.8.19

A routine lap chole in a 55 years old female turned out to be unexpedtedly difficult, resulting in considerable bleeding from the liver bed. This was controlled with cautery and pressure with gauze, and several pieces of gelfoam were later pressed into the area. Discharged the next day, had to be readmitted on 19.8.19 with abdominal distension. Treated as ileus with IV fluids and recovered by 21.8.19.

2.9.19

Another lap chole case had to be readmitted on 4th PO day for severe abdominal pain, possibly pancreatitis. resolved with conservative treatment in 2 days.

23.9.19

Another lap chole landing up in trouble. A young 30 years old male underwent a very difficult lap chole due to the frozen Calot’s triangle and a very thick walled gall bladder. Postoperatively had a bile leak which was 200 cc on the first postoperative day and then continued to decrease in amount gradually drying up in 18 days. MRCP shown below reported a small collection and a ? kink and narrowing at the site of cystic duct-CBD junction. Was it a cystic duct blow-out?

24.9.19

Cystogastrostomy and cholecystectomy in a 65 years old female who was admitted more than 2 months back in ICU for severe pancreatitis. Had developed a big pseudocyst which continued to persist and cause pressure symptoms.

A lot of necrotic debris was also removed from the depth of the pseudocyst cavity.

9.10.19

An attempted lap chole in an 85 years old man (Dr NP Singh’s case) was abandoned, due to dense adhesions and the liver being very hard and cirrhotic with innumerable nodules on its surface.