Background / aim of the study: The purpose of our study is to compare our initial laparoscopic gastric cancer surgery experience with the existing literature. Material (patients) and methods: The research encompassed a cohort of individuals who were diagnosed with gastric cancer and subsequently underwent curative laparoscopic total or subtotal gastrectomy within the timeframe of January 2021 to June 2023. This study presents a retrospective analysis of the demographic, surgical, and pathological data of a cohort consisting of 20 patients who underwent laparoscopic surgery for gastric cancer. Results: The mean surgical duration for laparoscopic total gastrectomy (LTG) was 290 ± 52.3 minutes, whereas for laparoscopic subtotal gastrectomy (LSG), it was 310 ± 39.4 minutes. One patient who underwent laparoscopic subtotal gastrectomy (LSG) had a collection that required percutaneous intervention as a result of stump leakage, classified as Clavian Dindo 3a. Additionally, another patient developed atelectasis, classified as Clavian Dindo 2, which required a modification in their medical treatment. The mean duration of hospitalization for the LTG group was identified to be 9.3 days, whereas the LSG group had an average length of stay of 12.3 days. Conclusion: It can be argued that our limited experience correlated with the existing literature, as evidenced by the average operating times reported in previous studies. Specifically, Aktimur et al. reported an average operating time of 255.8 ± 37.2 minutes for LTG, while Jeong et al. reported an average operating time of 292 ± 88 minutes. The mean number of lymph node harvesting for laparoscopic total gastrectomy (LTG) in the case series conducted by Fecso et al. is reported to be 24.78, while in the case series conducted by Lu et al., it is reported to be 36. Based on these findings, it can be inferred that our observed number is in proximity to the figures reported in Western case series. The findings of our case series correlate with existing literature. Laparoscopic surgery for the treatment of gastric cancer is considered a favorable therapeutic approach

Aim of the study: This study aims to evaluate supervised machine learning algorithms in predicting 90 days post-operative mortality in gastrointestinal and HPB surgeries and comparing them with standard logistic regression methods. Methods: We evaluated various supervised machine learning classification algorithms like gradient boosting, K-nearest neighbours, random forest, and support vector machines with standard logistic regression methods. We used accuracy and the Receiver operating curve to compare the methods. 60% of the data were used for training, 20% for validation and 20% for testing. We used JASP 0.16.04 by the University of Amsterdam to run machine learning algorithms and statistical analysis. Results: We used data from 504 patients who have undergone gastrointestinal and hepatopancreatic biliary surgery between April 2016 and March 2023. We analyzed algorithms for predicting 90 days post-operative mortality based on features like Major surgeries, Surgeries for malignancies, age, CDC grade of surgeries, Intraoperative hypotension, Open vs Laparoscopic surgeries, ASA grade, Emergency surgeries, Operative time, Intraoperative blood product used, colorectal surgeries, small intestinal surgeries, HPB surgeries, upper gastrointestinal surgeries and hernia. Test accuracies were 96% for gradient boosting, 90% for K-nearest neighbours, 96% for the random forest, 94% for support vector and Areas under the ROC curve were 0.802 for gradient boosting, 0.489 for K-nearest neighbours, 0.934 for random forest and 0.5 for support vector algorithms. Accuracy and Area under the ROC curve with standard logistic regression method were 94% and 0.757. Features of importance in decreasing order were ASA, operative times, blood products, small bowel surgeries and Age. Conclusion: Supervised machine learning algorithms particularly gradient boosting and random forest predicted 90 days post-operative mortality more accurately than logistic regression and such models can be part of the preoperative evaluation in gastrointestinal and HPB surgeries.

Background: Post-hepatectomy liver failure (PHLF) is a common complication in patients with liver cancer. Biomarker-based methods, such as the Fibrosis-4 (FIB-4) index, can potentially reduce PHLF through identification and risk mitigation in high-risk patients. We conducted a systematic review to summarize the literature around the use of the FIB-4 index for predicting PHLF in liver cancer patients. Methods: We searched PubMed and Scopus (1 January 2010 - 31 December 2022) to identify the pertinent literature. We used predefined eligibility criteria to select studies for inclusion in our review. Information on study characteristics, FIB-4 index prognostic utility (sensitivity, specificity, predictive values, Area Under Curve – AUC), and comparisons with other liver function tests was collected for each included study. Study quality was assessed with the QUIPS checklist. Basic descriptive statistics were used to analyse the data obtained from included studies. Results: We identified 6 published studies for our review. Most studies were from China (5/6, 83.3%), and sample sizes ranged from 140-1353 patients. All studies were assessed to have had a low risk of bias. FIB-4 had a reported sensitivity for PHLF of 65.2-75% and a reported specificity for PHLF of 83.3-93%. The AUCs reported for FIB-4 when used to predict PHLF ranged from 0.647 to 0.758. The prognostic utility of the FIB-4 index was generally comparable to other more complex liver function tests. Conclusion: The FIB-4 index appears to be a promising, non-invasive method for predicting PHLF in patients with liver cancer, warranting further research on this biomarker-based index.

Background: Surgical site infections (SSIs) are a significant cause of morbidity and mortality worldwide, especially in resource-limited settings. This study aimed to describe the incidence and spectrum of microbiological infection in patients attending a South African quaternary hospital. Patients and methods: This was a retrospective analysis of patients who had surgery between 2012 and 2016 at a quaternary hospital in KwaZulu-Natal Province, South Africa. High volume specialties including orthopaedic, gynaecologic, vascular, and general surgery were studied. Patients were identified from the hospital admissions database. Demographic characteristics and selected surgical variables were collected directly from the hospital admissions database. The study outcome was SSI up to 30 days postoperatively, established by reviewing microbiology test orders and laboratory reports. The laboratory reports were also used to establish the microbiology of SSIs. Data were descriptively analysed. Results: Of the 6620 patients included in this analysis, 609 developed SSI (Overall SSI incidence rate = 9.2 per 100 procedures). Overall, the most common micro-organisms were Staphylococcus species (28.6%) and culture negative SSI (18.1%). SSI incidence was highest in the vascular surgery specialty (Incidence rate: 36.4 per 100 procedures). For each speciality, important micro-organisms were as follows - Orthopaedic surgery: Culture-negative SSI, 45.2%; Gynaecologic surgery: Culture-negative, 29.4%; Vascular surgery: Staphylococcus species, 30.1%; General surgery: Staphylococcus, 36.2%. Conclusion: This study highlights the high incidence of SSIs, particularly culture-negative SSI, in resource-limited settings such as South Africa. Improved preventative and diagnostic strategies are needed to reduce the burden of SSIs in this setting.

Background: There are reconstructing methods of the alimentary tract after TLG as Roux-en-Y anastomosis and functional Jejunal interposition (FJI), and each of these methods has its advantages and drawbacks. But, no consensus has been reached yet about the best method. We aim to assess the post-operative outcomes of performing FJI or the Roux-en-Y procedure then jejunum transection as reconstruction procedures of the alimentary tract after performing TLG in gastric cancer patients and to compare between both procedures regarding post-operative complications and functional recovery. Patients and methods: We included 100 cases with clinical and radiological evidence of gastric carcinoma stages I-III. Patients were randomly divided for 2 equal groups the first group underwent FJI and the second group underwent Roux-en-Y as reconstructive techniques after performing gastrectomy. We correlate between both groups of patients regarding, operative parameters, post-operative complications. Results: time of the operation in patients who underwent PJI procedure was longer than that in patients who underwent Roux-en-Y procedure (P 0.001). The postoperative hemoglobin, total protein and albumin in patients who underwent PJI procedure were higher than in patients who underwent Roux-en-Y procedure (P 0.001). The post-operative loss in bodyweight at 3 and 12 months in the group of patients who underwent FJI groups was less than that in group of patients who underwent Roux-en-Y (P = 0.011). Conclusions: performing jejunal interposition as a reconstructive post-gastrectomy procedure is more effective than performing Roux-en-Y anastomosis regarding lowed incidence of postoperative complications and improving long-term post-operative life quality of patients.

Aim: Surgery is the gold standard treatment for colon cancer. More than 90% of colorectal cancer patients receive surgical treatment. The traditional method is open colon surgery. In our study, we aimed to compare the cases who underwent open and laparoscopic colon surgery retrospectively. Materials and methods: Between January 1, 2015 and March 1, 2022, the clinical and pathological results of 181 patients who underwent colectomy under elective conditions in the Department of General Surgery and Surgical Oncology of Health Sciences University Ankara Training and Research Hospital were reviewed retrospectively and the cases who underwent open and laparoscopic surgery were compared. Results: Of the patients, 114 (63%) were male and 67 (37%) were female. There was a statistically significant difference between the cases who underwent open surgery and laparoscopic surgery in terms of operation type, tumor localization, N stage, number of lymph nodes removed, specimen length, operation time, neoadjuvant treatment, disease-free survival and survival (p 0.05). Conclusion: Although the intraoperative and post-operative findings of the cases who underwent open and laparoscopic surgery for colorectal cancer were similar, when the oncological results were evaluated, it was concluded that open surgery was superior to laparoscopy.

Background and aim of the study: To compare early versus interval LC in the treatment of acute benign gallbladder disease with their subsequent benefits or hazards with focused monitoring of the perioperative outcome and in-hospital economic burden, as the time-setting of surgery remains an area of considerable variation despite laparoscopic cholecystectomy (LC) being the definitive management. The precise cut-off time beyond which it is not advisable to operate on these patients has yet to be conclusively defined in the literature. Patients and methods: Using data from a prospective multicentric study conducted on nine hundred patients with ACC examining the outcomes of LC (either early or interval) with focusing on the cost-effectiveness and perioperative outcomes. Results: Six hundred patients of group A had early LC While three hundred patients had interval LC. Females represented 73.3% of all studied populations. Patients with WBCs > 11000 were 450. there was a statistically significant decrease of operative time in group B when compared to group A (84.63 ± 9.82 vs 109.30 ± 9.65 minutes respectively). Higher hospital costs were observed in group B than in the other one. There was a statistically significant decrease of LOS in group A when compared to group B (3.76 ± 1.07 vs 9.36 ± 1.47 days, respectively). Earlier return to work was noticed in group A with a significant difference. Conclusion: Early LC in ACC is a feasible solution with a low complication rate, short hospital stays, and less cost. The benefits of this approach will likely be improved health outcomes for patients and cost savings for healthcare providers. Interval laparoscopic cholecystectomy is an alternative solution especially when equipment or experience are lacking but carry the risk of readmission or more attacks.

Introduction: Stichopus vastus; sea cucumbers, is an invertebrate which is rich in glycosaminoglycans (GAGs). This sea cucumber has long been implemented as traditional therapy that was used in wound healing remedy. The current study is designed in order to explore the effect of GAGs from integument wall of S. vastus species for wound healing properties in rats by intra-peritoneal injection with GAGs extract daily. Methods: Twelve (12) male Sprague Dawley rats were divided into two groups (n = 6) which are control group; given phosphate buffer saline (PBS) and treated groups of GAGs; 2 mg/kg. Rats weight from 250-400 grams were treated with GAGs daily for 12 days. Wound size were measured at Day 1, 6 and 12. At Day 12, the rats were sacrificied and skin graft were taken for macroscopic and microscopic evaluation. Results: The wound healing is significantly faster in 2 mg/kg GAGs group compared to control at 6th and 12th Day based on the wound contraction rates (p 0.05) and wound healing percentage (p 0.05). Conclusion: Thus, it can be hypothesized that Glycosaminoglycans (GAGs) from S. vastus has potential to act as promoter for pro-inflammatory effect on wound healing.

Background: Bariatric surgery is still evolving and numerous procedures with a plethora of variations are presently advocated as a method of choice to treat morbid obesity. Aim and objectives: The current study aimed to compare short-term outcomes of sleeve gastrectomy operation with those of combined sleeve gastrectomy and loop bipartition procedure regarding weight loss, operative time, hospital stay and early complications. In addition to improve our surgical management strategy of obesity and its related co-morbidities by using the best surgical procedure. Patients and methods: A prospective randomized controlled trial was conducted in the period between January 2020 and November 2022. It was conducted at Department of General Surgery of Assiut University Hospitals. Results: The main findings of the current study were; 1) mean operative time was significantly lower operative time in group A (72.89 ± 8.98 vs. 98.11 ± 10.11 (minute), 2) majority of both groups had no complications, 3) group B had significantly lower mean percentage of excess weight loss (73.45 ± 10.12 vs. 60.16 ± 9.99 (%) and body mass index after one year was insignificantly lower in group B (29.12 ± 1.45 vs. 34.22 ± 1.11 (kg/m2) after one year and 4) group B had significantly higher frequency of remission rate of diabetes mellitus (90.5% vs. 68.4%) and gastroesophageal reflux disease (90.9% vs. 52.3%). Conclusion: The percentage excess weight loss at 12 months after SASI bypass was significantly higher than after sleeve gastroectomy. SASI bypass conferred better remission and improvement in diabetes mellitus and gastroesophageal reflux disease and had longer operation time than sleeve gastroectomy. Both procedures had similar weight loss at 6 months postoperatively and comparable complication rates.

Background and objectives: Trans Arterial Chemo Embolisation (TACE) is the treatment choice for most unresectable hepatocellular carcinoma (HCC) patients. Post-embolisation syndrome (PES) is the most common complication. PES definition was a constellation of fever, nausea/vomiting, and abdominal pain within the first 72 hours post-TACE regardless of the need for systemic medication. This study aims to identify the risk factors of PES and its association with patients’ survival. Variables included demographic, clinical characteristics, tumour characteristics and procedure characteristics were identified. Study design and method: This is a retrospective study in a single centre, Hospital Universiti Sains Malaysia, Kelantan. This study showed that 90 HCC patients underwent TACE procedures between 1st January 2016 and 31st December 2019. Variables included demographic, clinical characteristics, tumour characteristics and procedure characteristics were collected. Data were entered and analysed using Statistical Package for the Social Sciences (SPSS) version 22. Results: The prevalence of PES among 90 patients was 25.6% (n = 23). There was a significant association between related variables towards PES, such as the number of tumours (p = 0.039), lobar involvement (p = 0.024) and chemotherapy type (p = 0.035) when adjusted for other variables. Also, there was a significant association between PES and survival duration (p = 0.001). Majority of the patients with no PES found highest in the group of survival duration of more and equal to 12 months (n = 56, 62.2%). Conclusion: We found that PES is a clinically significant event in HCC patients. There were few risk factors identified in this study. PES is associated with a worse prognosis in terms of survival rate for patients who experience it.

Background: Most abdominal surgery in South Africa is still via an open laparotomy, which confers an increased risk of developing an incisional hernia. Adherence to current guidelines by The Hernia Interest Group of South Africa to use mesh in repair of all incisional hernias are poor. This study aims to contribute toward improvements in management of patients undergoing large VH surgery (>10 cm width) with the “Component Separation Technique”, through increasing our understanding of post-surgical recurrence, complications and its application in certain population groups with similar results to mesh techniques. Methods: A retrospective chart review was undertaken from 1 January 2015 to 31 April 2021 of 66 patients who underwent incisional hernia repair using the open anterior component separation technique, who were followed up for a minimum of 12 months. Variables included demographic profile, risk factors, and complications. Data was analysed with Student’s t-tests, Fisher’s exact 2-sided tests and Mann-Whitney U tests. Results: The median age of presentation was 45 years, with a female predominance (77.3%). In most instances, obstetric and gynaecological related procedures (36.36%) or trauma-related laparotomies (13.64%) preceded the formation of secondary VH. Surgical risk factors included HIV (12 patients, 18.2%), Type 2 Diabetes Mellitus (11 patients, 16.7%), and smoking/tobacco use (1 patient, 1.5%). Mean BMI was 29.77 (standard deviation 6.2), with a range from 17 to 45. Median size of the hernia was 10 cm in width (EHS W3). Most patients (85%) did not experience post-operative complications. Hernia recurrence rate at 12 months was 6.1%. There were 3 known postoperative deaths. Conclusions: Component separation technique of large ventral hernias of greater than 10 cm is a safe and feasible option in a resource limited setting if used in certain population groups however further research is needed to establish its role.

Background: Breast cancer is a major cause of mortality among women if not treated in early stages. Early screening and diagnosis have a lot to do with the therapeutic effect of prognosis. The lymphatic drainage areas of the breast (axillary, internal mammary, supraclavicular nodal groups and Intramammary lymph nodes) are the nodes most likely to be involved in patients with metastatic breast cancer. Aim and objectives: prediction of axillary lymph nodes status by detection of intramammary lymph nodes (IMLNS) by radiological study and pathological data correlation with radiological results. Patients and methods: The present study was descriptive prospective study that at general surgery department (Department 7), Mansoura University Hospitals from August 2021 till August 2023. And it included 54 patients with breast cancer. Results: There was a statistically significant difference between the studied groups as regard Axillary LN status by radiography, SLNB and relation between molecular subtypes and intramammary lymph node detected by pathology. Conclusion: the incidence of ALN and IMLN metastasis in breast cancer women is high. Preoperative imaging modalities have high sensitivity and diagnostic accuracy for the assessment of both lymph node groups. However, the specificity becomes very low in the assessment of IMLNs.

Background: Immunohistochemistry (IHC) plays an important role in the management and outcome of breast cancer. It has been observed that the responses to same chemotherapy or hormone therapy are different among cases of breast cancer. Despite the recognition of the IHC markers and appropriate treatment, poor response or relapse can be attributed to the discordance between marker status of breast tumors and axillary lymph nodes. Therefore, our aim is to assess the molecular markers in primary breast cancer/tumor (PBT) and metastatic axillary lymph nodes (ALN) and their correlation with outcome in patients undergoing treatment for carcinoma breast in our hospital. Methods: This Prospective Observational study was done in an institution in northern India dedicated for people of low socioeconomic strata. Study was done over a period of two years. 85 patients with operable breast carcinoma without neoadjuvant chemotherapy were included in the study. Results: Mean value of age (years) of patients was 50.73 ± 9.8 Majority (96.47%) of patients had invasive breast carcinoma – no special type. 77.65% of patients had stage IIA breast carcinoma at the time of presentation. IHC of primary tumor correlated with that of axillary lymph nodes mostly and discordance was statistically insignificant. Conclusion: We concluded that discordance in immunohistochemistry profile of primary breast tumor and axillary lymph nodes are statistically insignificant and it is not the reason of poor outcome in certain cases of carcinoma breast.

Introduction: After head and chest trauma, abdomen injury is the 3rd most common occurrence. For assessment of such trauma patients, ultra sonography has been found to be a reliable diagnostic tool which is accessible, portable and non-invasive. Aim: This study was carried out to known the presentation of different findings detected by ultra sonography in trauma patients presenting to the emergency room of a tertiary care centre in India. Material and method: All adult patients presenting with abdominal trauma from 1st October 2021 to 30th September 2023 were enrolled in the study. After initial monitoring and resuscitation, patients were subjected to ultra sonography examination of abdomen. Patient’s demographic data and ultra sonography findings were recorded. Results: Total of 43,986 patients attended the Emergency Room. Out of these 3,024 were abdominal trauma patients. The most common mechanism of injury reported was assault. Liver injury was the commonest solid organ injury seen in abdominal trauma patients. Conclusion: Abdominal trauma is more common in young males. The ultra sonography was found positive in 21.39% of patients. Whatever be the mode of injury or organ injured, it is the economic burden which the country has to bear. Hence, preventive strategies must be formulated and implemented effectively.

Background: Superficial thrombophlebitis (ST) has traditionally been considered a benign thrombotic condition in most patients. Patients with localization along the large veins and near their junctions with the deep veins are at a particularly high risk of developing DVT and PTE. The initial approach of ligation of the great saphenous vein for the purpose of prophylaxis has been replaced in the guidelines by the increasingly widespread use of anticoagulants in the last 30 years. Тhe surgical approach seems to be neglected for no good reasons during that time. The aim of our study is to investigate early and late complications in our large series of patients with ST and surgical treatment and to reveal, in particular, long-term survival rate. Material and methods: Presented are the results of simple surgical treatment of 190 consecutive patients with ST localized in upper half on femoral area by clinical signs or less then 5 cm by ultrasound is presented. Saphenous vein ligation was performed mainly under local anesthesia with additional therapy. Results: Early local standard surgical complications were found in 4.2% of the patients with 0% mortality. In a 6-year period, 14 patients or 7.4% died, and there was no significant difference for the period with the general population, the group of deceased was 12 years older. Conclusion: These data show that saphenous vein ligation in the subgroup of patients with ST in the upper part of the thigh by clinical or ultrasound evidence is still a reliable and safe method for significantly reducing the risk of DVT and PE with excellent long term survival rate at acceptable price.

Background: High perianal fistula is a surgical challenge because it carries a high risk for postoperative incontinence. Seton placement has been described to decrease the risk of that complication. In this trial, we evaluated the efficacy of cutting seton as a surgical treatment of high anal fistula combined with partial fistulotomy or fistulectomy. Patients and methods: Thirty patients were included in our prospective study. All of them were diagnosed with high perianal fistula and managed by cutting seton with fistulotomy or partial fistulectomy. The patients were followed-up for two years after the procedure. Results: Most patients were men (70%), and their ages ranged between 18 and 60 years. Transsphincteric fistula was the most common type, followed by intersphincteric and suprasphincteric types. The mean operative time was 25.4 minutes. The seton fell spontaneously in 53.3% of cases, while it was manually removed in the remaining cases (after an average duration of 41.4 days). The mean duration of wound healing was 3.2 weeks, while it took an average of 3.4 weeks to return to daily activities. Gas and liquid incontinence were encountered in 20% and 3.3% of cases, respectively, while only one patient developed recurrence (3.3%). Conclusion: A partial fistulectomy or fistulotomy with cutting Seton is an effective and safe management option for high anal fistula with low recurrence and incontinence rates. Stable and slow cutting of the sphincter appears to have a positive impact on the maintenance of continence.

Transdermal administration techniques have gained popularity due to their advantages over oral and parenteral methods. Noninvasive, self-administered delivery devices improve patient compliance and control drug release. Transdermal delivery devices struggle with the skin’s barrier function. Molecules over 500 Da and ionized compounds don’t pass through skin. Few medications can be given this way. Encapsulating pharmaceuticals in transfersomes is one solution. Bilayered liposomes encapsulate lipophilic, hydrophilic, and amphiphilic drugs with better penetration efficiencies than standard liposomes. Transfersomes are elastic in nature, allowing them to flex and squeeze through pores substantially smaller than their size while remaining whole. This article describes the concept of transfersomes, their mode of action, several techniques of manufacture and characterization, and factors influencing their properties, as well as their latest applications in the transdermal administration of pharmaceuticals.

Cystic lesions of the spleen are not common in surgical practice. It is roughly divided into parasitic and non-parasitic, with the latter being the rarer entity. Splenic cysts, encountered during pregnancy is extremely rare. We present a case of a 32-year-old pregnant lady, with 6 months history of left hypochondriac mass. Clinically, a mass was palpable, extending from left hypochondriac region to above umbilicus. Initial suspicion of mass arising from bowel was ruled out as an ultrasound revealed splenomegaly with multiloculated cystic lesion surrounding the splenic parenchymal. Elective laparotomy and splenectomy was performed and viability of fetus was preserved. Post operatively, her recovery was uneventful. Histopathology examination showed benign epithelial cyst of the spleen.

Introduction: Pyomyositis is a very rare infection of the skeletal muscle. Case presentation: We report a case of a male patient who presented with right thoracic-axillary pain, along with fever and rigors for three weeks. The diagnostic with a CT scan revealed an abscess and grade of pyomyositis was grade two. The treatment approach was surgical drainage of the abscess. Discussion: Pyomyositis is an acute life-threatening abscess forming infection and it’s diagnosis is usually delayed, because the affected muscle is deeply situated. Conclusion: Early detection and treatment are important to avoid dismal outcomes.

Hollow viscus injury caused by blunt abdominal trauma counts for 4-15% of the trauma cases. It is common to have associated adjacent solid organ or structure injury together with hollow viscus injury. However, isolated gastric perforation following blunt trauma is relatively rare clinical entity with a low incidence reported in literatures yet potentially fatal in delayed diagnosis. Isolated gastric perforation frequently associated with delayed presentation due to its anatomical location and imposed a diagnostic challenge. Hence, clinical diagnosis of perforated gastric needs high index of clinical suspicious and may need additional imaging to support the clinical diagnosis. In contrast, delay in diagnosis and intervention may lead to significant morbidity and poorer outcomes. Mortality increases parallel with delay in time for operative intervention. We hereby discuss a case of a teenager with isolated delayed gastric perforation following a motor vehicle accident.

Bouveret syndrome, an extremely rare cause of gastric outlet obstruction, is characterized by the impaction of a gallstone, which has either passed into the duodenum or pyloric channel via a cholecystoduodenal or cholecystogastric fistula. In this case report, a 63-year-old female sought emergency care due to diffuse abdominal pain. The patient cursed with severe abdominal pain, oral intolerance, and signs of peritoneal irritation. Evaluations, including X-rays, CT scans, and lab tests, revealed an intestinal obstruction caused by a 6.5 cm stone, necessitating exploratory laparotomy. An enterotomy led to favorable clinical progress. In conclusion, this case underscores the significance of prompt diagnosis and intervention in managing this challenging yet rare biliary condition.

Background: Congenital biliary tract dilatation is a common malformation in children and is classified into several types. Choledochocele is a rare type of choledochal cyst that is still debated today. Its etiology and treatment are distinct from those of the other types. We present a case of choledochocele complicated with choledocholithiasis and acute pancreatitis. Case presentation: Here we report the case of an eight-year-old boy who presented a cholangitis. Radiological assessments showed dilatation of extrahepatic and intrahepatic bile ducts with dilatation of the terminal part of the terminal bile duct protruding into the duodenal lumen and microlithiasis into extrahepatic ducts. The patient presented acute pancreatitis that recovered well, then he was operated on. The diagnosis of choledochocele was confirmed with cholangiography. A partial resection of the cyst and marsupialization were done with an open procedure. Conclusion: Choledochocele is a rare type of choledochal cyst that has the lowest risk of developing cholangiocarcinoma. The optimum treatment is partial resection or endoscopic unroofing.

Neuroendocrine tumour (NET) arising from the colonic mesentery is rare. We present a case of a 37-year-old woman who had concurrent benign right ovarian teratoma and mesenteric cyst NET arising from the descending colon mesentery. Her symptoms were consistent with a non-functioning NET. Based on the histopathological features, the mesenteric cyst was a grade 1 NET. We report the surgical decision making process for our patient and her outcome. We briefly outline the management for mesenteric cyst NETs.