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    . US examination revealed hydatid disease of liver with rupture in the biliary tract and dilation of bile ducts.

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    Police look into her background, and find a more complicated life than anyone knows. The most efficient treatment of this complication is lavage of the biliary tree followed by radical excision of the cyst and free drainage of the remaining cavity.

    In the present study the effect of the implementation of a clinical pathway has been assessed both on the outcome of patients planned for laparoscopic cholecystectomy, and on available bed capacity.

    Emergency procedures were excluded.

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    The numbers of same-day discharges OLC, one-night stays, and hospitalisations were compared.

    Patient characteristics studied pre-operatively were age, gender, ASA score and indication for cholecystectomy.

    The clinical pathway will be outlined in detail during the presentation.

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    Clinical outcome no postoperative complications, re -admission rate 5. Introduction of a clinical pathway results in a significant rise in same-day discharge following laparoscopic cholecystectomy without loss of patient satisfaction, and provides more available hospital beds and substantial cost savings.

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    A randomised trial including patients undergoing elective laparoscopic cholecystectomy raised the question of usefulness of routine drainage in this setting.

    We conducted a prospective randomised trial focusing on patients undergoing attempted laparoscopic cholecystectomy for acute cholecystitis.

  • Hepatic resection, most over left hepatic lobectomy, should be performed in a rescue of segmental dilation and stricturing of efficacy duct.
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  • The patient was defined to the operating theater where we strived an excision of the dome, drainage of the cavity, cholocystectomy and placement of a chole-docal T-tube.
  • The operations were performed or supervised by the same surgeon. Endpoints of the study were to detect any difference in morbidity, postoperative pain and hospital stay between the two groups by analyzing the results on an intention-to-treat basis.

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