Papillary carcinoma thyroid with metastasis to ectopic cervical thymus

Papillary carcinoma of thyroid is the most common type of thyroid neoplasm which is usually confined to the thyroid and tends to metastasize to regional lymph nodes. Distant metastasis occur in up to 15% of cases. Thymic metastasis from any malignant carcinoma is extremely rare with only four cases reported in medical literature. We report a case of papillary carcinoma of thyroid metastasizing to ectopic cervical thymus which has not been previously reported

Comparative study of reconstructive procedures after distal gastrectomy for carcinoma stomach: Jejunal interposition with Billroth I and Billroth II.

Objectives: The objective of this study was to evaluate the nutritional benefits of jejunal interposition against Billroth I and Billroth II and to compare operative time and postoperative complications. Study design: Prospective randomized study. Methods: This study included 45 patients who underwent distal gastrectomy for Ca stomach. Patients were divided into three groups randomly. Group A included 15 patients with reconstruction by jejunal interposition, group B included 15 patients reconstructed by Billroth I gastroduodenostomy and group C included 15 patients reconstructed by Billroth II gastrojejunostomy. Gastrointestinal continuity was restored by hand-sewn anastomosis in one layer traversing through all coats. Results: Maximum incidence of the disease in our series was in the age group 60-70 years. Males were commonly affected with the male to female ratio of 5.4:1. The mean operating time in jejunal interposition group was longer than Billroth I and Billroth II procedures (256, 195, 209 mins respectively). No serious postoperative complications occurred in either group. Weight loss was observed in all the three groups postoperatively although it was less in jejunal interposition group. Regarding serum nutritional parameters there was significant improvement in haemoglobin, serum cholesterol, blood glucose, total protein, serum albumin, serum iron and B12 levels. Conclusions: Jejunal interposition after distal gastrectomy can recover physiological continuity of digestive tract and improve quality of life without complications. Significant advantage of the new procedure was observed in terms of nutritional status

Closure of the Common Duct -Endonasobiliary Drainage Tubes vs. T Tube: A Comparative Study

For the last century T tube drainage of the bile duct has remained standard practice following choledochlithotomy. It vents the biliary tree, provides route for cholangiography and management of residual stones. However, T tubes are associated with significant complications. This retrospective study compared the use of Endonasobiliary drainage tubes and the T tube in 66 patients who underwent open choledocholithotomy for effectiveness and complications. Both groups were statistically comparable. Only 15.15% patients in the Endonasobiliary drainage group, while 45.45% patients in the T tube group developed complications. Severe complications such as biliary peritonitis and intraperitoneal collections were noted only in the T tube group. The Endonasobiliary drainage tube was removed significantly earlier and patients from this group were discharged earlier as compared to those in the T tube. The Endonasobiliary drainage tube is as effective as the T tube in postoperative biliary drainage and allows cholangiograms to be performed. Its use is associated with less complications and it can be removed safely earlier than the T tube. Thus patients have a shorter time with tubes and can be discharged home earlier