PURPOSE: Single incision laparoscopic cholecystectomy (SILC) is a surgical method to treat gallbladder disease designed to reduce postoperative pain and improve cosmetic results. However, pure SILC (pSILC) has several inherent limitations. In this study, we report the surgical outcomes of SILC with needlescopic grasper (nSILC) compared with those of pSILC and conventional three-port laparoscopic cholecystectomy (TPLC).METHODS: This retrospective study enrolled 103 patients who underwent laparoscopic cholecystectomy for benign gallbladder disease in our hospital between January 2013 and January 2015. Among them, 33 patients underwent pSILC, 35 underwent nSILC, and 35 underwent TPLC. We collected demographic characteristics and operative data to analyze outcomes between groups.RESULTS: All procedures were done by laparoscopy and the gallbladder of each patient was completely removed. Women and younger patients were more to undergo SILC than TPLC. Analysis showed that the operation time of the nSILC group was longer than that of the TPLC group, but shorter than that of the pSILC group (skin to skin operation time [pSILC: 65.2±19.1 min, nSILC: 49.7±12.9 min, and TPLC: 43.4±14.7 min, p<0.001], and major procedure time [pSILC: 42.2±18.7 min, nSILC: 25.9±8.9 min, and TPLC: 23.4±12.7 min, p<0.001]). There were no significant differences between the groups for patient visual analogue scale score, length of hospital stay, or intraoperative blood loss.CONCLUSION: nSILC is feasible surgical method in patients with benign gallbladder disease compared to TPLC, and that is an effective procedure to overcome the disadvantage of pSILC.
Cholecystectomy ; Cholecystectomy, Laparoscopic ; Female ; Gallbladder ; Gallbladder Diseases ; Humans ; Laparoscopy ; Length of Stay ; Methods ; Pain, Postoperative ; Retrospective Studies ; Skin

Background and Objectives: Proximal submandibular stone is not a rare disease. The aim of this study is to evaluate the surgical outcomes of 3 different ways to treat proximal submandibular stone: intraoral removal of stone (IORS) with sublingual gland (SLG) resection, IORS without SLG resection and submandibular gland (SMG) resection. Subjects and Methods: We prospectively reviewed the surgical outcomes of IORS with SLG resection group (22 patients), IORS without SLG resection group (35 patients) and SMG resection group (22 patients). To evaluate the surgical outcomes, we analyzed the location and size of stones, mean operation time, mean hospital stay, mean postoperative degree of pain based on a visual analog scale (0–10), and incidence of complications. Results: There were no significant differences between the mean diameter of stones and lengthfrom the hilum to stones. The mean operation time was shorter in the IORS without SLG re-section group than that in IORS without SLG resection group, and was significantly shorter than that of the SMG resection group. The mean hospital stay of the IORS without SLG resection group was also shorter than that of IORS with SLG resection group, and was significantly short-er than the SMG resection group. IORS without SLG resection group felt less pain than IORS with SLG resection group and SMG resection group. Four patients who underwent IORS without SLG resection experienced transient and mild SMG swelling, and mild paresthesia was noted on the same side. All patients recovered within 3 months. Intraoral removal of proximal SMG stones exhibited several advantages over SMG resection in terms of hospital stay, mean operation, time and postoperative pain. Conclusion Based on our results, we suggest that IORS without SLG resection be selected as the primary procedure for the removal of proximal submandibular stones rather than SMG resection.

No abstract available.
Pancreatectomy* ; Spleen*

No abstract available.
Cholecystectomy* ; Cholecystectomy, Laparoscopic*

PURPOSE: BRAF(V600E) mutation is the most common genetic alteration in papillary thyroid cancer (PTC) and has been associated with poor prognostic factors. The purpose of the present study is to investigate the frequency of the BRAF mutation in PTC with and without benign thyroid nodules (BN). METHODS: 98 DNA samples were extracted from frozen tissues of 51 PTC and 47 BN specimens of 70 patients and were divided into four group: PTC with BN, PTC alone, BN with PTC and BN alone group. We investigated the BRAF mutation by sequencing and clinicopathologic characteristics. RESULTS: Total positive rate of BRAF mutation was 23.5% in the two PTC groups. That rate of the PTC with BN group was 10.7% and the PTC alone group was 39.1%. Positive rate in the PTC with BN group was lesser than the PTC alone group and had statistically difference (P=0.02). The positive rate of BRAF mutation was 7.1% in the BN with PTC group and 5.3% in the BN alone group. Positive rate in these two group was not statistically different (P=0.80). CONCLUSION: The frequency of BRAF mutation in PTC with concurrent BN was lower than in PTC alone. This result suggests that the effect of BRAF mutation is lesser associated with PTCs with BN than PTC alone group.
DNA ; Humans ; Polymerase Chain Reaction ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule*

Primary retroperitoneal mucinous cystadenocarcinoma is a rare tumor, and it is similar to its ovarian counterpart, but it is without any evidence of ovarian, pancreatic or any other extra-retroperitoneal origin. The histogenesis of this neoplasm remains uncertain. Mucinous or colemic metaplasia of the retroperitoneal mesothelium has recently been proposed as its origin. A 39-year-old woman was diagnosed with a 13-cm cystic lesion in the left retroperitoneum; this was mucinous cystadenocarcinoma and no primary tumor was identified. We report here on a primary retroperitoneal mucinous cystadenocarcinoma that involved the splenic hilum, and we include a review of literature.
Adult ; Cystadenocarcinoma, Mucinous ; Epithelium ; Female ; Humans ; Metaplasia ; Mucins*

PURPOSE: Limited traction has been an obstacle in the advancement of single incision laparoscopic cholecystectomy (SILC). Adequate retraction is necessary for safe performance of a cholecystectomy. In this study, we introduce our method for securing CVS for prevention of bile duct injury during performance of SILC and evaluated the effectiveness of the snake liver retractor. METHODS: A total of 148 patients who underwent needlescopic assisted SILC (nSILC) from February 2011 to February 2012 at Uijeongbu St. Mary's Hospital, Uijeongbu, Korea were analyzed. Patients were categorized into two groups: G roup I consisted of patients who underwent nSILC without use of a snake liver retractor from February 2011 to October 2011 (n=51) and group II consisted of patients who underwent nSILC using a snake liver retractor from October 2011 to February 2012 (n=97). Patient characteristics and operative outcomes were compared between groups in order to evaluate the effectiveness of use of a snake liver retractor during performance of SILC. RESULTS: There were no differences in age, sex, BMI, and history of previous abdominal surgery. However, more difficult surgeries for acute cholecystitis were performed in group II. Nevertheless, no differences in operative outcomes, such as operative time, rate of bile spillage, open conversion rate, intraoperative complication, and postoperative hospital stay were observed between groups. In addition, CVS identification time was rather shorter in group II, compared with group I. CONCLUSION: Results of this study showed that nSILC using a snake liver retractor can allow for achievement of CVS safely and for expansion of indication for SILC through improvement of exposure and obtaining adequate traction.
Achievement ; Bile ; Bile Ducts ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis, Acute ; Humans ; Intraoperative Complications ; Korea ; Length of Stay ; Liver ; Operative Time ; Snakes ; Traction