Background: Traditionally cholecystectomy in cirrhotic patients is restricted to severe biliary disease, because of high morbidity and mortality following the procedure. Laparoscopic cholecystectomy (LC) was originally contraindicated in cirrhotic patients because of associated portal hypertension and coagulopathy. Patients and methods: Fifty cirrhotic patients underwent LC in Ain Shams University Hospital from January 2007 till December 2008. Results: There were no mortalities in our group. Mean age was 45.6 years and mean operative time was 74.5 min. Conversion to open cholecystectomy occured in 12 patients (24%). Postoperative complications occurred in 9 patients (18%). Mean hospital stay was 3.4 days in Child A and 6.8 days in Child B. Conclusion: Laparoscopic cholecystectomy can be performed safely in cirrhotic patients with well compensated liver functions.
Background: We evaluated the results of the Doppler-guided hemorrhoidal artery ligation procedure in the management of symptomatic hemorrhoids to determine its effectiveness, safety, short and long term outcome.Patients and methods: Between January 2007 and December 2008, fifty consecutive patients with symptomatic hemorrhoids were treated by Doppler-guided hemorrhoidal artery ligation method. All patients were treated in insurance hospital in Riyad, KSA and Palestinian hospital, Cairo, Egypt. Postoperative pain was measured with visual analog scale (1-10). Patients were followed up at intervals of one week, 1, 3, 6 and 12 months postoperatively. At every postoperative follow up visit, wound healing was observed and any complication was reported.Results: Thirty five patients had their operations performed under general anesthesia. The operative time ranged between 19-45 minutes (mean 32± 3.6 minutes). The mean postoperative pain score was 6.1 ± 1.3 in the first postoperative day. The complications rate was low and the most common long term complication was persistent prolapse in three patients (6%).Conclusion: Doppler-guided hemorrhoidal artery ligation procedure in the management of symptomatic hemorrhoids is safe, effective and is associated with minimal long term complications. The procedure can be done on an out-patient basis.
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