Asymptomatic cholelithiasis in bariatric practice

Background: The need for simultaneous cholecystectomy for asymptomatic cholelithiasis in patients undergoing bariatric intervention has not been proven. The experience of managing patients with obesity and concomitant disease cholelithiasis is presented. Aim: to determine the indications for simultaneous cholecystectomy and bariatric surgery in the combination of morbid obesity and a asymptomatic cholelithiasis. Methods: The results of observation of 37 patients with initially asymptomatic cholelithiasis were analyzed: 27 patients underwent bariatric surgery and simultaneous cholecystectomy, and 10 patients underwent only bariatric surgery. The immediate and long-term results of the treatment, the quality of life of patients and the cost of the treatment were assessed. Results: During 12 months of the follow-up, none of the patients who underwent simultaneous cholecystectomy developed any complications. Of the 10 patients in the observation group, 3 were operated on. Two patients underwent laparoscopic cholecystectomy for acute cholecystitis and one patient was operated on for choledocholithiasis with obstructive jaundice. The greatest improvement in the quality of life was observed in the gastric bypass group with simultaneous cholecystectomy. The treatment cost per patient was lower in that group, too. Conclusion: In the presence of asymptomatic cholelithiasis in a patient with morbid obesity, bariatric intervention and simultaneous cholecystectomy prevents the development of complications of cholelithiasis and thereby potentially improves the quality of life and reduces the cost of medical care

Using 3D Imaging to Preoperatively Plan Facelift Procedures for the Lower Third of the Face and Neck

The pursuit of youth and attractiveness is a fundamental desire in contemporary society. For many individuals, the appearance of visible signs of aging, such as skin laxity, gravitational changes in facial and neck soft tissues, and loss of harmonious proportions, can be psychologically distressing. The choice of effective methods for addressing these changes depends on their specific characteristics, the patient’s anatomical features, and the type of facial aging. The introduction of 3D imaging to determine the hyoid bone level, the volume of soft tissue structures in the cervico-mental area, ptosis of subplatysmal structures, and the volume of submandibular glands, in addition to ultrasound study of the submental projection at the preoperative stage, are key for making the best decisions regarding preoperative planning. This case report aims to illustrate how modern imaging techniques are a fundamental part of the preoperative assessment of the mid and lower third of the face to ensure the most favorable aesthetic outcomes for each patient