Mirizzi syndrome is infrequently associated with fistula formation, particularly a unique biliopleural fistula. The ideal therapeutic strategy remains diverse across guidelines, which usually includes surgical excision to eliminate the source of infection. We reported a case of a 60-year-old jaundiced female with pleural effusion resulting from a biliopleural fistula. Imaging revealed a cystic lesion close to the periphery of the upper right diaphragm, connected to the gallbladder. Following initial pleural drainage, an abdominal exploration was conducted to excise the fistula and remove the gallbladder. A multidisciplinary approach is essential for obtaining optimal outcomes for patients with biliopleural fistula.

Bulbar urethral ischemic necrosis (BUIN) is an unfortunate complication of urethroplasties. This is a result of previous unsalvageable strictures resulting from previous repairs. Here, we present the first case of entero-urethroplasty performed using a sigmoid flap. A 27-year-old man visited the urology clinic with a complaint of urine retention on cystostomy 1 year prior. He had a motor vehicle accident that injured the urethra. He had previously undergone excision and primary anastomosis (EPA) urethroplasty and redo EPA; however, the results were unsatisfactory. Entero-urethroplasty was performed using a sigmoid colon flap harvested carefully from the patient's sigmoid colon, and reconstructive options are limited to BUIN. The sigmoid flap reconstruction appears for treating BUN. This study's limitation is the short follow-up period. Therefore, further studies and long-term follow-up should be performed to assess the effectiveness of this technique.
sigmoid ; stricture ; urethra ; urethroplasty

Background: s/Aims: The efficacy of neoadjuvant transarterial chemoembolization (N−TACE) in resectable hepatocellular carcinoma (HCC) remains open to debate. While N−TACE may reduce tumor size, its impact on long-term outcomes is inconclusive. Methods: This meta-analysis reviewed studies on N−TACE before surgical resection vs. liver resection (LR) single large hepatocellular carcinoma (SLHCC) up to March 2023 from four online databases. Results: Five studies with 1,556 patients were analyzed. No significant differences between N−TACE and LR groups were observed in 1-, 3-, or 5-year overall survival (OS) and disease-free survival (DFS). No significant differences were noted in intraoperative blood loss between groups. Subgroup analysis showed favorable 1-, 3-, and 5-year OS with combination chemotherapy N−TACE (combination group), and better 1-year OS in the LR group with single-agent chemotherapy N−TACE (single-agent group). Five-year DFS favored LR in the single-agent group, and N−TACE in the combination group. Conclusions Managing SLHCC requires intricate considerations, and the treatment strategies for this challenging subgroup of HCC need to be improved. The influence of N−TACE on long-term survival depends on the specific chemotherapy regimen employed, and its impact on intraoperative blood loss in SLHCC appears limited.

Chronic fibroinflammatory pancreatitis causes irreparable damage to the pancreatic parenchyma. This frequently results in food restrictions, painkiller addiction, and serious quality of life impairment in children. We observed a 13-year-old girl who had previously been hospitalized multiple times and had undergone acute pancreatitis arrived with excruciating abdominal pain and recurrent hematemesis. A chronic intra-pseudocyst bleed and an ampulla of Vater hemorrhage were discovered during an upper gastrointestinal endoscopy. A 3×2×1 cm pancreatic head pseudocyst was discovered on the magnetic resonance cholangiopancreatography, however the computed tomography scan revealed a pancreatic head pseudocyst, pancreatic duct stones, and substantial peripancreatic inflammation. The multidisciplinary team determined that Frey’s surgery was the most efficient method to minimize her suffering. No complications occurred during the healing phase following surgery, and two years later, neither recurrence bleeding nor abdominal pain appeared. In summary, Frey’s method is a secure and efficient intervention when applied by a multidisciplinary team.