ABSTRACT… Background: An intestinal stoma is an opening of intestine on the anterior abdominal wall made surgically. The commonly performed procedures include colostomy and ileostomy. The purpose of the present study was to identify indications for commonly performed intestinal stomas and to study complications related to it. Objective: To identify indications for commonly performed intestinal stomas and to study complications related to it. Study Design: Observational study. Setting: Department of General Surgery, Unit-B, Lady reading Hospital, Peshawar. Period: 1 st Jan 2013, to 31 st Dec 2013. Subjects and Method: A total of 106 patients who underwent surgery and ended up in intestinal stomas, ileostomy or colostomy, were included in the study. Indications, immediate and late complications of stomas were recorded. Results: A break up of 106 patients of different intestinal stomas. Majority (61.32%) of patients were males. There were 49 ileostomies and 57 cases of colostomy making a total of 106 patients. Main indications of Ileostomy were enteric perforation (55.10%), and intestinal tuberculosis (20.40%). Main indications of colostomy were penetrating injuries (50.88%), and intestinal obstruction. In a total of 106 stomas local complications appeared in 23 (21.69%). Skin excoriation, ulceration, lap and wound infection were the most common respectively. Seventy eight stomas including 36 ileostomies and 42 colostomies were closed on an average of 3 months after primary operation. There were 7 cases of wound infection, 2 anastamotic leak-ages and one mortality (1.3%) in the stoma reversal group. Conclusion: Common indications for intestinal stomas were abdominal penetrating trauma, enteric perforation, intestinal obstruction and intestinal tuberculosis. Main complications included local skin problems, wound infection and retraction.
Objectives: To determine the frequency of choleducholethiasis in patientswith symptomatic gall stone disease and evaluation of primary closure of common bile ductwithout T-Tube placement after open exploration as a treatment modality in its management.Study Design: Prospective (descriptive) study. Setting: Surgical Unit of Postgraduate MedicalInstitute, Lady Reading Hospital, Peshawar. Period: One year from 15-03-2013 to 15-03-2014. Subjects and methods: Total 0f 206 patients of symptomatic gallstones disease wereincluded in the study to find out frequency of choledcholithias and patients with common bileduct (CBD) stones were subjected to open choledochotomy and primary choledochorrhaphy,and follow up of patients was done to find out any post operative complication. Results: Atotal of 206 patients underwent open cholecystectomy during the study period. The age ofthe patients ranged from 17 to 70 years with mean of 44.24±1.23 years. Most of the patientswith symptomatic gall stones disease were female in the age range of 41-50 years. Frequencyof choledocholethiasis was 24 out of 206 constituting 11.65%. Among the patients with CBDstones 4 were male constituting 16.6% and 20 were female that is 83.33% with male to femaleratio of 1:4 respectively. Mean hospital stay of the patients in which open CBD explorationand primary repair was performed was 7.25±1.45 days. Complications developed in only 4patients constituting 16.66%. Complications were wound infection in 2 (8.33%) patients, intraabdominalpus collection in 1 (4.16%) patient and bile leak in 1 (4.16%). One patient lost fromfollow up. In none of the patients retained CBD stones and stricture observed. Conclusions:There should be low
ABSTRACT… Objectives:To determine the frequency of choleducholethiasis in patients with symptomatic gall stone disease and evaluation of primary closure of common bile duct without T-Tube placement after open exploration as a treatment modality in its management. Study Design: Prospective (descriptive) study. Setting: Surgical Unit of Postgraduate Medical Institute, Lady Reading Hospital, Peshawar. Period: One year from 15-03-2013 to 15-03-2014. Subjects and methods: Total 0f 206 patients of symptomatic gallstones disease were included in the study to find out frequency of choledcholithias and patients with common bile duct (CBD) stones were subjected to open choledochotomy and primary choledochorrhaphy, and follow up of patients was done to find out any post operative complication. Results: A total of 206 patients underwent open cholecystectomy during the study period. The age of the patients ranged from 17 to 70 years with mean of 44.24±1.23 years. Most of the patients with symptomatic gall stones disease were female in the age range of 41-50 years. Frequency of choledocholethiasis was 24 out of 206 constituting 11.65%. Among the patients with CBD stones 4 were male constituting 16.6% and 20 were female that is 83.33% with male to female ratio of 1:4 respectively. Mean hospital stay of the patients in which open CBD exploration and primary repair was performed was 7.25±1.45 days. Complications developed in only 4 patients constituting 16.66%. Complications were wound infection in 2 (8.33%) patients, intraabdominal pus collection in 1 (4.16%) patient and bile leak in 1 (4.16%). One patient lost from follow up. In none of the patients retained CBD stones and stricture observed. Conclusions: There should be low threshold for suspecting CBD stones in cases of symptomatic gallbladder stones disease. Key words:CBD exploration (Choleduchotomy), Primary CBD repair (Choledochorrhaphy), T-Tube, CBD stones (choledocholethiasis) Article Citation: Hussain S, Aslam V, Khan SM, Jan WA. Choledocholithiasis;Frequency of choleducholethiasis and evaluation of primary closure of common bile duct after open exploration as a treatment modality in its management.
Background: An intestinal stoma is an opening of intestine on the anteriorabdominal wall made surgically. The commonly performed procedures include colostomy andileostomy. The purpose of the present study was to identify indications for commonly performedintestinal stomas and to study complications related to it. Objective: To identify indications forcommonly performed intestinal stomas and to study complications related to it. Study Design:Observational study. Setting: Department of General Surgery, Unit- B, Lady reading Hospital,Peshawar. Period: 1st Jan 2013, to 31st Dec 2013. Subjects and Method: A total of 106 patientswho underwent surgery and ended up in intestinal stomas, ileostomy or colostomy, were includedin the study. Indications, immediate and late complications of stomas were recorded. Results: Abreak up of 106 patients of different intestinal stomas. Majority (61.32%) of patients were males.There were 49 ileostomies and 57 cases of colostomy making a total of 106 patients. Mainindications of Ileostomy were enteric perforation (55.10%), and intestinal tuberculosis (20.40%).Main indications of colostomy were penetrating injuries (50.88%), and intestinal obstruction. Ina total of 106 stomas local complications appeared in 23 (21.69%). Skin excoriation, ulceration,lap and wound infection were the most common respectively. Seventy eight stomas including 36ileostomies and 42 colostomies were closed on an average of 3 months after primary operation.There were 7 cases of wound infection, 2 anastamotic leak-ages and one mortality (1.3%) in thestoma reversal group. Conclusion: Common indications for intestinal stomas were abdominalpenetrating trauma, enteric perforation, intestinal obstruction and intestinal tuberculosis. Maincomplications included local skin problems, wound infection and retraction.
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