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Relation between Gallbladder Wall Thickness, Assessed by Sonography, and Difficulties in Laparoscopic Cholecystectomy

Background: Laparoscopic cholecystectomy is the standard treatment for symptomatic gallbladder disease. Preoperative prediction of a difficult laparoscopic cholecystectomy can help the surgeon to prepare better for intraoperative risk and the risk of conversion to open cholecystectomy.
Objectives: Evaluation of the influence of gallbladder wall thickness, assessed by sonography preoperatively, on the outcome of laparoscopic cholecystectomy and to evaluate any intra- or postoperative complications in relation to them.
Patients and Methods: This prospective clinical trial conducted in Department of Surgery, Al-yarmouk Teaching Hospital, between October 2010 and October 2012.Abdominal sonography performed in 122 consecutive patients before laparoscopic cholecystectomy. The surgeon re-verified sonographic findings in the operating room.
Difficulty of laparoscopy was evaluated with multiple parameters related to the gall bladder wall thickness, so classified as easy or difficult laparoscopy or conversion.
Results: Out of 122 patients with cholecystolithiasis on sonography, we encountered straight forward laparoscopic cholecystectomy in 87 patients (71.31%), difficult laparoscopic cholecystectomy in 27 (22.13%) and the procedure was converted to open cholecystectomy in 8 patients (6.55%). 47 patients(38.5%) had sonography revealing gallbladder wall thickness (>3 mm), and 75 patients (61.47%) had wall thickness < 3mm .
Conclusions: Gallbladder wall thickening is the most sensitive indicator of technical difficulties during laparoscopic cholecystectomy. Such difficulties may require conversion to Laparotomy.

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Publication Date
Wed Jan 02 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Irrigtion of Gallbladder bed with bupivacaine for post- operative pain relief in laparoscopic cholecystectomy.

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

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Publication Date
Sun Nov 21 2021
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Laparoscopic cholecystectomy with harmonic scalpel

Background: The Harmonic scalpel (HS) has been proven to be an effective, efficient, and safe instrument for dissection and hemostasis in both open and laparoscopic surgical procedures. The primary use of the HS in laparoscopic cholecystectomy (LC) has been for the division of the cystic artery and liver bed dissection. Advancements in the Harmonic scalpel blade tip now provide for the reliable ultrasonic division and closure of the cystic duct.
Objectives: This study was planned to compare the clips and cautery (CC) method of laparoscopic cholecystectomy (LC) versus LC using HS as regard to the safety and efficacy for symptomatic gallstone disease.
Patients and methods: This is a prospective study conducted in Baghdad Teaching Hos

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Publication Date
Sun Jul 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Laparoscopic cholecystectomy with harmonic scalpel

Background: The Harmonic scalpel (HS) has been proven to be an effective, efficient, and safe instrument for dissection and hemostasis in both open and laparoscopic surgical procedures. The primary use of the HS in laparoscopic cholecystectomy (LC) has been for the division of the cystic artery and liver bed dissection. Advancements in the Harmonic scalpel blade tip now provide for the reliable ultrasonic division and closure of the cystic duct.
Objectives: This study was planned to compare the clips and cautery (CC) method of laparoscopic cholecystectomy (LC) versus LC using HS as regard to the safety and efficacy for symptomatic gallstone disease.
Patients and methods: This is a prospective study conducted in Baghdad Teaching Hos

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Postoperative Nurses' Interventions for the Patients with Laparoscopic Cholecystectomy at Baghdad Teaching Hospitals

Objective: The study aimed to assess the postoperative nurses' intervention for the patients with laparoscopic
cholecystectomy and to determine the relationship between Nurses' interventions and their demographic
characteristics.
Methodology: Quantitative design (a descriptive study) was started from 20th November 2012 up to 1st
September 2013. Non-probability (purposive sample) of (50) nurses, who were working in surgical wards, were
selected from Baghdad teaching hospitals (Baghdad Teaching Hospital, Digestives System and Liver Teaching
Hospital, AL-Kindy Teaching Hospital, and AL-Kadhimiyia Teaching Hospita). The data were collected through
the use of a constructed questionnaire, which consisted of two parts; the

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Publication Date
Thu Jan 02 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Laparoscopic Cholecystectomy; It’s Complications and Causes of Conversion to Open Cholecystectomy.

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

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Publication Date
Thu Jan 02 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The value of ultrasound to differentiate between benign and malignant duct ectasia

Background: Mammary duct ectasia is defined as dilated duct larger than 2 mm in diameter seen in fibrocystic changes, ductal epithelial hyperplasia, papiloma, DCIS. US has a significant role in diagnostic breast imaging. It is most commonly used as an adjunctive test in characterizing lesions detected by other imaging modalities or by clinical examination

Objective: This study was designed to investigate differences in ultrasonographic findings between malignant and benign mammary duct ectasia.

Patients and Methods: From November 2010 to July 2011, 100 womem with mammary duct ectasia lesions depicted on sonograms were included in this study. We evaluated the ultrasonograp

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Publication Date
Wed May 01 2019
Journal Name
Annals Of Medicine And Surgery
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Publication Date
Thu Jan 02 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Laparoscopic subtotal cholecystectomy in patients with acute cholecystitis

Background: Using Laparoscopic approach, Cholecystectomy is made hazardous by distortion of the anatomy of Calot's triangle by acute or chronic inflammation and dense omental adhesions. Laparoscopic subtotal cholecystectomy (LSTC) without cystic duct ligation is an alternative to conversion to open surgery in difficult cases.


Results:
Fifty cases of LSTC were performed, 32 of them were males and the remaining 18 patients were females. The age of study group was ranged (18 – 75) years with a median of (46) year. The median operating time was about 90 min. and the mean duration of hospital stay was 7.3±2.2 days. There were 8 patients (16%) with postoperative bile leak, most of them recover s

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Publication Date
Sun Jan 03 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Complications of laparoscopic cholecystectomy

Background: 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

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Surgical management of staple line leak after laparoscopic sleeve gastrectomy

Background: Laparoscopic sleeve gastrectomy (LSG)is derived from the biliopancreatic diversion with duodenal switch operation(BPD-DS). Specific and potentially severe complications of LSG are bleeding from the staple line and staple line leakage (SLL). A staple line leak may result in severe morbidity with potential sepsis and multi- organ failure.
Objectives: To review our experience with the definitive surgical management of staple line leak Post sleeve gastrectomy and its outcomes.
Patients and methods: retrospective review of patients who underwent definitive surgical treatment of staple line leak post sleeve gastrectomy from May 2014 till June 2016 at Saint Raphael center of morbid obesity, Primary surgery was laparoscopic sle

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