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"Hot" Laproscopic Cholecystectomy 🔴Principles remain the same 🔴Know bailout options ➡️Subtotal 🔴Gallbladder decompression 🔴Identification of Rouviere's sulcus if present 🔴Endo pledget very useful in these cases 🔴Suction/irrigation ➡️blunt dissection 🔴Demonstrate CVS

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Derby Pancreaticobiliary & Robotic AWR Unit

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11,422 просмотров • 5 месяцев назад •via X (Twitter)

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Tips for Retrieval of CBD Stone during Transcholedochal LCBDE 🔴CBD >8mm 🔴Atraumatic graspers useful 🔴"Milking" CBDS 🔴5mm choledochoscope with 0-Tip basket ➡️Gentle "to-and-fro" motion ➡️Irrigation 🔴Withdraw choledochoscope over basket wire with trapped CBDS 🔴Extend choledochotomy #FOAMed #GITwitter #Surgery #SoMe4Surgery #HPB
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𝗟𝗮𝗽𝗮𝗿𝗼𝘀𝗰𝗼𝗽𝗶𝗰 𝗙𝗲𝗻𝗲𝘀𝘁𝗿𝗮𝘁𝗲𝗱 𝗦𝘂𝗯𝘁𝗼𝘁𝗮𝗹 𝗖𝗵𝗼𝗹𝗲𝗰𝘆𝘀𝘁𝗲𝗰𝘁𝗼𝗺𝘆 Patient Presentation: 🔵History of severe cholecystitis 🔵CT on index admission showed: ➡️Cholecysto-colic fistula ➡️Air locules on GB ➡️Figure 1 below 🔵Follow up CT (~4 months later): ➡️Good improvement with apparent resolution of fistula as absence of air in GB ➡️Figure 2 below 🔵Symptomatic gallstones 🔵Listed for planned biliary surgery Operative Approach: 🔴Colonic adhesion to GB fundus 🔴Fused hepatocystic triangle ➡️Decision to perform subtotal cholecystectomy 🔴Dissection plane (window) identified between GB and colon 🔴Presumed area of fistula tract detached with cuff of GB wall 🔴Stone retrieved and GB opened to identify cystic duct ostium on opening GB ➡️Closed with 2/0 Vicryl 🔴Gallbladder dissected off as far as safe to do so 🔴Detached colonic attachment with GB cuff ➡️No obvious fistula tract ➡️The area was under run to achieve haemostasis 🔴Cystic artery transfixed with figure of 8 suture 🔴Drain x 1 ➡️Removed after 24 hours 🔴Uneventful postop course #FOAMed #MedTwitter #GITwitter #SoMe4Surgery #HPB

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🚨The Political Agenda of Cockroach Party ! ➡️ To defeat Yogi Adityanath in UP ! ➡️ To help AAP winning Punjab ! 🔴 CJP is a Non-Conventional Proxy Movement ! 🔴 It’s not a youth Movement for the betterment of the country ! 🚨Started by AAP and supported by Samajwadi Party to help these Parties to win Elections !

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THE DISAPPEARANCE OF MADELEINE McCANN 🧵 Dog handler Martin Grime (former FBI) describes what happened the moment the dogs entered Apartment 5A: 🔴 “As soon as I came in, the dog was very excited. As a handler, I can read his body language.” 🔴 “It appeared to me that as soon as he entered the apartment, he picked up a scent he recognised.” 🔴 “There was enough scent in that area for him to give a bark indication.” 🔴 “It was a strong indication — positive for what he is trained to find.” 🔴 “When we moved into the bedroom, he lost interest — because he had already found the source he was looking for.” 🔴 “This dog only barks when he finds something.” Then the second dog, Keela, the crime-scene dog: 🔴 “She will only indicate when she has found HUMAN blood.” 🔴 “At the same location, Keela gave a passive indication — freezing on the spot — which tells me there is human blood present.” 🔴 SWAB 3A (behind the sofa): “All confirmed DNA components match the DNA profile of Madeleine McCann.” ❗ Two dogs. ❗ Independently trained. ❗ Different disciplines. ❗ Same location. This isn’t coincidence. This is corroboration. #MadeleineMcCann #McCann #TrueCrime

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96,088 просмотров • 9 месяцев назад

🚨 Iranians rejoice as multiple Iraqi PMU commanders are eliminated in a targeted strike in Habbaniyah. 🔴 Saad Dawai al-Baiji — Commander of PMF operations in Anbar 🔴 Haider al-Maamouri — Security Director of PMF in Anbar 🔴 Wathiq al-Fartousi — PMF Intelligence Director in Anbar These same PMU forces were brought in by the Islamic Republic to suppress protests, with widespread reports of killings, rape, and other abuses during the January 2026 unrest. This feels like long-overdue justice.
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🚨 Iranians rejoice as multiple Iraqi PMU commanders are eliminated in a targeted strike in Habbaniyah. 🔴 Saad Dawai al-Baiji — Commander of PMF operations in Anbar 🔴 Haider al-Maamouri — Security Director of PMF in Anbar 🔴 Wathiq al-Fartousi — PMF Intelligence Director in Anbar These same PMU forces were brought in by the Islamic Republic to suppress protests, with widespread reports of killings, rape, and other abuses during the January 2026 unrest. This feels like long-overdue justice.

The Iran Watcher 🇮🇷

33,348 просмотров • 4 месяцев назад

Galibaf, Speaker of the Iranian Parliament: The Zionist regime's attack on Iran was definitely coordinated with the USA 🔴 Netanyahu stated three goals of this attack: changing Iran's political system, destroying the nuclear industry, and eliminating the country's missile potential. But he was defeated on all three fronts. 🔴 However, this victory does not mean we did not suffer losses — this is certainly not the case. In this war, we lost more than a thousand martyrs. 🔴 The security and economic doctrine of the Zionist regime has collapsed; Israel can no longer present itself as a safe territory for investments. 🔴 We opened a "highway" from Iran to the Zionist regime, along which missiles were continuously launched. 🔴 The sky and land of the Zionist regime were under Iran's control. We carried out pinpoint strikes from north to south — wherever we wanted. 🔴 The accuracy of our missile hits in recent days exceeded 90%. 🔴 The actual number of casualties in Israel is much higher than official statements — this is confirmed by scientific criteria. 🔴 Iran's control over the enemy's land and airspace was the main reason for the Zionist regime's failure. 🔴 We disabled Israel's military and defense centers. 🔴 In the First and Second World Wars, Iran declared neutrality, but did the great powers accept this neutrality? The Allies and coalition considered Iran's geography a "bridge to victory." 🔴 And today, Iran's geography, along with its material and spiritual capabilities and the strength given to it by Islam, has strategic and decisive importance. Therefore, even if we do not deal with Israel, it will deal with us.
0:38

Galibaf, Speaker of the Iranian Parliament: The Zionist regime's attack on Iran was definitely coordinated with the USA 🔴 Netanyahu stated three goals of this attack: changing Iran's political system, destroying the nuclear industry, and eliminating the country's missile potential. But he was defeated on all three fronts. 🔴 However, this victory does not mean we did not suffer losses — this is certainly not the case. In this war, we lost more than a thousand martyrs. 🔴 The security and economic doctrine of the Zionist regime has collapsed; Israel can no longer present itself as a safe territory for investments. 🔴 We opened a "highway" from Iran to the Zionist regime, along which missiles were continuously launched. 🔴 The sky and land of the Zionist regime were under Iran's control. We carried out pinpoint strikes from north to south — wherever we wanted. 🔴 The accuracy of our missile hits in recent days exceeded 90%. 🔴 The actual number of casualties in Israel is much higher than official statements — this is confirmed by scientific criteria. 🔴 Iran's control over the enemy's land and airspace was the main reason for the Zionist regime's failure. 🔴 We disabled Israel's military and defense centers. 🔴 In the First and Second World Wars, Iran declared neutrality, but did the great powers accept this neutrality? The Allies and coalition considered Iran's geography a "bridge to victory." 🔴 And today, Iran's geography, along with its material and spiritual capabilities and the strength given to it by Islam, has strategic and decisive importance. Therefore, even if we do not deal with Israel, it will deal with us.

Sprinter Observer

11,445 просмотров • 1 год назад

🚨🇬🇧 “STAY AT HOME. ISOLATE FROM OTHERS.” – SUPER-FLU MESSAGE RAISES EYEBROWS Pharmacist Oliver Picard is urging people with the so-called “super-flu” to isolate at home as cases are said to be surging and hospital admissions hit record levels. 🔴 Public advice stresses isolation and staying indoors 🔴 Language mirrors Covid-era messaging almost word for word 🔴 Claims of record admissions dominate headlines 🔴 Little independent scrutiny of severity versus seasonal flu norms This sounds uncomfortably familiar. Many are asking a simple question: does anyone actually know people seriously affected by this “super-flu” – or is the threat being amplified once again? If it really were as widespread and severe as claimed, would it not be visible in everyday life? Same script. Same tone. Same pressure. Credit: GB News
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British Intel

124,243 просмотров • 8 месяцев назад