Rogier Crolla

To assess the difference in safety of laparoscopic cholecystectomy performed by residents and staff surgeons. St. Antonius Hospital, Nieuwegein, the Netherlands. Retrospective study. Results of 649 laparoscopic cholecystectomies performed by staff surgeons experienced in laparoscopic surgery, by residents under supervision of a staff surgeon, by residents without supervision and by inexperienced surgeons, were compared. Patients were comparable, except for liver function disorders and raised sedimentation rates, of which there were more in the group operated by the non-supervised residents, compared with the staff surgeons. Average operation time was 57 minutes in all four groups. Non-supervised residents had more retained stones than staff surgeons (19 vs 6%) and reported more bleeding during surgery than staff surgeons (21 vs 8%). Conversion rate was the same (3.9%) in all four groups. Complications occurred in 5.7%; this also was the same in the four groups. Residents following a...

We report a case of the cholesterol crystal embolization syndrome concomitant with an unusual cutaneous localization. Extensive embolization of cholesterol crystals caused severe necrosis of the prepuce. Circumcision was performed and histopathological examination confirmed the diagnosis.