RESUMEN
Objective Ventral hernia repair is a widely practiced surgical procedure worldwide. The objective of this paper is to evaluate and analyze the results of a hybrid approach for treating ventral hernias. Methods All patients with clinically and radiologically proven ventral hernia underwent hybrid laparoscopic ventral hernia repair at Princess Royal University Hospital, London, United Kingdom using a retrospective approach with the same surgical team. Large defects >10 cm, inguinal hernia, para-stomal hernia, incarcerated patients, and spigelian hernia were excluded. We utilized the laparoscopic approach for the dissection and isolation of the sac and used the port site for the delivery of mesh into the abdominal cavity. Results Our study comprises 67 patients, with 39 males (58.2%) and 28 females (41.8%). The median age in our study group was 41 years (range: 18-65 years). The median BMI was 38 kg/m2 (range: 24-52 kg/m2). The majority of the cases were umbilical or paraumbilical hernias (n = 46). The median defect size in our study was 5.4 cm (range: 2-10 cm). The median operative time was 67 minutes. We have not encountered any recurrences in this group. Conclusion This hybrid approach combines the advantages of both the open and laparoscopic approaches.
RESUMEN
Objective A percutaneous cholecystostomy (PC) is a suitable option for treating acutely inflamed gallbladders. Its use has been postulated before for treating acute cholecystitis (AC), especially in elderly populations. The primary aim of our study is to analyze and present the positive results of PC as a bridge to laparoscopic cholecystectomy. Methods All patients who underwent PC at our hospital, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, GBR, from October 2020 were reviewed using a retrospective approach. Results Our study comprises 123 patients, with 72 females (58.5%) and 51 males (41.4%). In our study, many patients had significant comorbidities, and some of them were categorized as high-risk due to their frailty and medical conditions. The majority of the patients were in American Society of Anaesthesiologists' (ASA) groups II and III (45, 61), respectively. Though hospital stays can depend on variable factors, in our experience, the mean hospital length of stay was 12.7 days. In our study, 119 patients (96.8%) had the procedure through the interventional radiological approach, while only four patients had it through the laparoscopic approach. The transhepatic route for drainage was more commonly practiced at our center and was used in 108 patients. At the time of writing this article, 54 patients have already had a laparoscopic cholecystectomy (LC) done as an interval procedure after surpassing the acute attack of cholecystitis, while 42 patients are still awaiting their surgical procedure. Conclusion Our results show that PC is a viable option, especially in cases of AC that are not responding to conservative treatments. Our study has shown low complications and conversion rates after PC. We believe PC is a safe and effective tool for managing severe and refractory cases of AC.