Background: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswith common bile duct calculus, dilated common bile duct, current attack of acute cholecystitis, those withabsolute contraindications to laparoscopic cholecystectomy, The data were collected prospectively to predictthe significance of association with patients’ characteristics. The time of operation was calculated from thefirst port site incision until the last port closure. All the intra operative events were recorded. Conversionsto open cholecystectomy were done by median or subcostal laparotomy according to the surgeon’s decisionand each patient’s condition. Results: In this study, the highest proportion of operations was categorizedas easy (58.3%), 28.3% of operations were considered difficult and 13.3% of them were very difficult. Asignificant association (P < 0.05) between operation difficulty and all of the following characteristics: Aging,obesity, history of previous biliary hospitalization, thickened bladder wall, pericholecystic collection, andlarge stones. Conclusions: The difficult laparoscopic cholecystectomy can be predicted preoperativelybased on number of factors, like: obesity, previous biliary admission, gall bladder wall thickness, ultrasoundfindings (stone size and pericholecystic fluid) and aging process, evaluating of such factors minimize thecomplications of laparoscopic cholecystectomy and conversion to the open procedure.
Background: Although pain after laparoscopic cholecystectomy is less intense than after open Cholecystectomy, some patients still experience considerable discomfort, and use of local anaesthetics irrigation is controversial.
Objectives :to evaluate the effect of intraperitoneal and port site instillation of local anaesthetics on pain relief in the first 6 hours postoperatively.
Patient and Method: Forty patients underwent elective laparoscopic cholecystectomy were included in this study and sample was divided into two equal groups. Group A received 20 ml of 0.9% normal saline instilled in the gallbladder bed, while group B received 20 ml of 0.25% bupivacaine instilled in
... Show MoreBackground: Cholecystectomy in cirrhotic patients is commonly followed by high morbidity and mortality, the incidence of hepatic cirrhosis has increased since last decade as well as the occurrence of complication such as liver failure, portal hypertension, and biliary disorders.
Patients and methods: laparoscopic Cholecystectomy was performed in 24 cirrhotic patients (18 child A and 6 child B) in an effort to obtain lower complications and mortality rates. The mean age of the group was 51.8 years, ten of the 24 patients were men and 14 female.
Results: intraoperative complications such as bleeding, dense adhesion and long operative time were recorded.
Conclusion: laparoscopic Cholecystectomy was safe and
Background: The laparoscopic cholecystectomy is the gold standard for treating the symptomatic cholelithiasis. Conversion is sometimes necessary due to finding unexpected pathology,intraoperative complications or unexpected technical errors .
Objectives: The aims of this study were to determine the complications and the predictive factors of conversion in patients undergoing laparoscopic cholecystectomy for various indications in elective and acute settings in a general hospital in order to reduce the incidence rates of both , complications and conversion of laparoscopic cholecystectomy to the open technique .
Patients and Methods: This is a prospective study includ
... Show MoreBackground: cholecystectomy is one of the most frequently performed operations. Open cholecystectomy has been the gold standard for over 100 years .laparoscopic cholecystectomy was
introduced in 1980s.
Patient and methods: Two hundred patients admitted to first surgical unit in Baghdad teaching hospital from first May 2007- first May 2009 with gall stone disease both symptomatic and
asymptomatic, of both genders and any age were evaluated by history, examination and investigations and data was collected.
Results: Two hundred patients underwent LC in the study period. 181(90.5%)were females and 19(9.5%)were males. The most common age group was between 21-40 years (55%), bleeding was the commonest compl
Background: Myelomeningocele is the single most common congenital anomaly that affects the CNS
and vertebral column. The third world countries having a higher incidence. The management is usually
surgical with relative high incidence of complications.
Objectives: to evaluate the possible risk factors that may predispose to early wound complications of
myelomeningocele.
Methods: This prospective study was carried out in the Surgical Specialization Hospital in Medical City
Complex - Baghdad from 2009-2012. 147 cases were included in the study. Requested data were
gestational age, type of delivery, gender, age at operation, type of suturing of the wound, tension of
suturing, duration of operation, site of the lesion,
Background: Laparoscopic cholecystectomy
has become the standard of care for the
elective management of cholelithiasis. Little
information exists, however, regarding the
appropriateness of this procedure in the setting
of acute symptomatology.
Objective: This study was designed to
evaluate the outcome of laparoscopic
cholecystectomy in acute and severe acute
cholecystitis based on early and late biliary
complications, their incidence and
management, and conversion rates to open
surgery.
Methods: A prospective study done between
April 2007 and November 2010, in the
department of general surgery, medical city
teaching hospital, Baghdad. Includes patients
with acute cholecystitis admitted f
Background: Venous thromboembolic (VTE) disease with i t ' s h i g h morbidity and mo r t a l i t y is currently one of the most serious postoperative complication, (DVT) can lead to
fatal pulmonary embolism (PE). or the development of post thrombotic syndrome.
Patients and methods: This is a prospective study which was carried on 85 patients had s i n g l e lower l i m b open fracture with no other major i n j u r i e s in other sites of body
(with the exception of superficial wounds or b r u i s e s ) .They were d i v i d e d i n t o groups according to age, gender, weight, type of fracture, methods of immobilization, duration of
h o s p i t a l i z a t i o n , duration of operation. All the patients includin
The research aims to verify the Role of Internal Auditing in Assessing the Risks of Strategic Operations (Acquisition) and then reflect on management decisions. Since all corporations wish to expand, growth and domination of the market may expose them to multiple risks that lead to failure. The research assumes two main hypotheses. First, there is no role for internal audit in evaluating the strategic operations (acquisition). Second, there is no relationship between internal auditing in assessing the risks of strategic operations (Acquisition) and management decisions. The data was collected by using a questionnaire distributed to a group of private bank employees. The statistical analysis regarding research rejected the two hyp
... Show MoreBackground: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild sys
... Show MoreThis review delves deep into the intricate relationship between urban planning and flood risk management, tracing its historical trajectory and the evolution of methodologies over time. Traditionally, urban centers prioritized defensive measures, like dikes and levees, with an emphasis on immediate solutions over long-term resilience. These practices, though effective in the short term, often overlooked broader environmental implications and the necessity for holistic planning. However, as urban areas burgeoned and climate change introduced new challenges, there has been a marked shift in approach. Modern urban planning now emphasizes integrated blue-green infrastructure, aiming to harmonize human habitation with water cycles. Resil
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