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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 the same region and 10 ml of 0.5% bupivacaine in divided doses at the trocar sites. The evaluation of postoperative pain was done at fixed time interval according to the numerical rating scale,and the request time of analgesics, pain site and vital signs were recorded.

Results: Pain score showed significant difference only at 0h and 1h with p-value <0.05, otherwise there was no significant differences in the following hours. Request for analgesia showed no statistically significant differences.

Conclusions: Intraperitoneal irrigation of bupivacaine is not so effective in decreasing pain after laparoscopic cholecystectomy.

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
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 b

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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
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
Sun Oct 01 2017
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Post-Operative Computed Tomography to Evaluate the Accuracy of Thoracic and Lumbosacral Spine Pedicular Screw Fixation

 Background: pedicular screw fixation is rapidly becoming a widely used method of spinal instrumentation. Despite improvement in design of instruments and surgical technique and the use of intra-operative fluoroscopy, pedicle cortical perforations occur endangering nearby neurovascular or extra vertebral structures.
Objective: This is a prospective (consecutive cases study) designed for Evaluation of incidence of pedicle screw misplacement in our study sample, compare our results to what is published in literature.
Patients and Method: This study involved 25 adult patients ( 10 males and 15 females ) their age ranged between ( 18 and 70 years) who underwent spinal surgery with pedicle screw fixation for different disorders of

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Publication Date
Sun Jan 02 2011
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Morbidity and mortality Post laparoscopic Cholecystectomy in cirrhotic patients

Background: 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

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Effects of local Infiltration of Bupivacaine in total hip and knee replacement for post - operative analgesia

Background: 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

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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
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
Mon Jan 02 2012
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Comparative study between ultrasound findings and intra-operative findings in non-traumatic Abdominal Pain:

Background: acute abdominal pain is one of the most common presentations in surgical wards. Ultrasound has been grown in popularity as an easy, quick and non-invasive imaging the abdomen. US is very useful means of non-invasively, modality for assessment of acute abdominal pain.
Objective: Study of the most common acute none traumatic abdominal diseases in adult patients admitted to Baghdad Teaching Hospital in department of surgery .Correlate the operative findings with sonographic features as to make the initial diagnosis of the diseases included in this study. Compare the diagnostic yield of abdominal ultrasound with that of computed tomography (CT).
Methods :The present study included eighty nine consec

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