Outcomes of carotid endarterectomy: Insights from a single-center retrospective cohort study.

OBJECTIVES: To analyze the outcomes of carotid endarterectomy in individuals with carotid artery stenosis in the context of a tertiary care center. METHODS: We carried out a retrospective cohort investigation between 2015-2022. Patient data includes demographics, risk factors, preoperative medications, and operative details. The primary outcomes were 30-day postoperative stroke and mortality rates, while the secondary outcome of the study was to assess the morbidity of the procedure. RESULTS: The mean age of the 54 patients was 66.9±9.88 years, and 57.4% were men. The 30-day stroke rate was 3.7%, and the mortality rate was 1.9%. Most patients did not develop postoperative complications; however, surgical site hematoma was the most common complication encountered (12.9%). Long-term follow-up showed disease regression in 68.5% of patients, with a minority of patients developing ipsilateral restenosis. Admission to an intensive care monitoring unit was the only independent predictor of postoperative complications. CONCLUSION: This study provided insights into the outcomes of carotid endarterectomy in patients with carotid artery stenosis, emphasizing the importance of careful patient selection and postoperative monitoring. Perioperative risks, including stroke and mortality, were within acceptable limits. Further research incorporating structured and non-structured data for predictive analyses, should explore refining patient profiling and optimizing treatment approaches for different carotid artery stenosis clinical and morphological presentations.

Primary squamous cell carcinoma of the gallbladder: Report of a rare neoplasm from the Eastern Province of Saudi Arabia.

INTRODUCTION: Primary squamous cell carcinoma of the gallbladder is extremely rare, and accounts for about 3% of all malignant gallbladder neoplasms. PRESENTATION OF CASE: We report the case of a 58-year-old woman who presented with acute onset epigastric pain radiating to the back. The initial diagnosis, based on radiological images, was an incidental gallbladder mass with multiple gallstones. A staging laparoscopy was performed, followed by exploratory laparotomy with radical cholecystectomy. Segments 4b and 5 of the liver and the first part of the duodenum with the transverse colon were also resected. Histopathology of the gallbladder mass revealed invasive moderately differentiated squamous cell carcinoma with infiltration of liver segments 4b and 5, the first part of the duodenum, and two pericaval lymph nodes (with lymphovascular and perineural invasion). The primary tumour was scored as pT3, pN2, M1, stage IVB, based on the American Joint Committee on Cancer classification, version 7. The patient was discharged postoperatively and started adjuvant chemotherapy. DISCUSSION: The best option for treating early-stage gallbladder cancer is radical surgery, while adjuvant chemo-radiation can also be beneficial. Our patient did not exhibit the typical symptoms of gallbladder cancer, and radiography was required for her diagnosis. Thus, additional work is needed to improve the detection of squamous cell carcinoma to improve the prognosis of patients like our own. CONCLUSION: Clinicians must be alert to the possibility of squamous cell gallbladder carcinoma, and gallbladder neoplasms should be among the possibilities considered during the differential diagnosis of symptoms related to the gallbladder.