Background: Laparoscopic cholecystectomy (LC), is a new modality of surgery late surfaced late 1980s. Compared with open cholecystectomy, LC is associated with less local pain, shorter hospitalization resulting in an early return to work, and a favourable cosmetic outcome. The aim of this study was to determine the incidence of major biliary injuries associated with LC.Methods: The patients have been admitted before operation and classical LC was done. Monopolar electrocautery was used. The insertion of postoperative intraperitoneal drain or nasogastric tube depended on the surgeons' preference and opinion. The data was evaluated according to outcome measures, such as bile duct injury, morbidity, mortality and numbers of patients whose operations had to be converted from laparoscopic to open.Results: One hundred and eighty-three (183) patients were initially included in this study. LC was accomplished successfully in one hundred and sixty-two patients (162), twenty-one have been converted to the conventional open method due to sever adhesions or unclear anatomy and they were excluded from this study. Among those who underwent LC, 5(2.73%) had major biliary injuries, another 6 (3.28) had minor injuries and 7 (3.82%) Spillage of Gallstones to the Peritoneal cavity.Conclusions: Biliary injury is the Achilles’ heel of laparoscopic Cholecystectomy. It can have devastating effects, turning the individual into a "biliary cripple". They mainly result from anatomical anomalies and errors of human judgment and are thus preventable to some extent.
Background: There is no doubt that laparoscopic cholecystectomy replaced open cholecystectomy as standard procedure for the treatment of symptomatic cholelithiasis. Conversion from laparoscopic cholecystectomy to open cholecystectomy is still required in many circumstance, this study aimed at exploring causes and incidence of conversion. Methods: This is a prospective study of 200 cases of laparoscopic cholecystectomy cases were performed in ALKARAMA Teaching Hospital from January2009 to January 2011. All cases were followed at the time of surgery by obtaining data sheet for the patient’s age, sex, time from the introduction of ports till decision of conversion and the cause of conversion if present.Results: Out of 200 laparoscopic cholecystectomy, 12 cases were converted into open cholecystectomy (6%). The major causes were : dense adhesions (4), bleeding (2), anatomical difficulties (2), impacted stone in Hartmann pauch (2), dilated cystic duct (1) and sever inflammation (1). Two of the conversions are males from 45 male patients underwent laparoscopic cholecystectomy, 10 cases are females from 155 female patients underwent laparoscopic cholecystectomy so the percentage of conversion for male patients is 4.44 % while for female patients is 6.45%.Conclusions: The conversion rate in this study is 6% and the most common cause for conversion is dense adhesions in the Calot’s triangle, no biliary duct injury that need conversion is found in this study and the rate for conversion is higher in female patients.
Background: Chronic cervical lymphadenopathy may result from a variety of different underlying diseases. It could be a sign of inflammation, metastatic tumor or lymphoma.Methods: This is a prospective study of 60 patients with cervical lymphadenopathy who attended Al Karama Teaching Hospital for the period (1/12/2008 to 1/2/2010). Data includes their demographic information, clinical presentation, investigations and histopathological results.Results: Twenty six patients were males (43.3%) and 34 were females (56.7%). The male to female ratio was 1:1.3. Age distribution had shown that the highest incidence occurred in those between (11-20) years old (15 patients, 25%), followed by those between (1-10) years old. The mean age was 31.2±21.5 SD. The most common cause of cervical lymphadenopathy was reactive hyperplasia (23 patients, 38.3%) followed by Tuberculous lymphadenopathy (15patients, 25%). Lymphomas (13 patients, 21.7%) and metastatic deposits (7 patients, 11.7%).Conclusions: The most common cause of cervical lymphadenopathy was reactive hyperplasia followed by tuberculous lymphadenopathy. Tuberculous lymphadenopathy continues to be a major health problem, and this may be explained by situation in this country in the last few decades that affected the socio-economic, health care and the living standard of population.
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