Background: Delayed interval cholecystectomy can be performed to overcome the logistical difficulties in performing ‘early urgent’ laparoscopic cholecystectomy (LC) within 72 hours of
admission with acute cholecystitis (AC), and to avoid earlier re-admission with recurrent AC in patients waiting ‘delayed interval’ cholecystectomy.
Objectives: To evaluate the safety and feasibility of ‘delayed urgent’ LC performed beyond 72 hours.
Methods: Patients admitted with AC were scheduled for urgent LC. Patients who underwent ‘early urgent’ LC were compared with those who had ‘delayed urgent’ surgery.
Results: Fifty consecutive patients underwent urgent LC for AC within 2 weeks of admission. There were no conversions and no bile duct injuries. Delayed surgery (n=36) neither prolonged operating time (90 vs. 85 minutes) nor increased operative morbidity (9.7% vs. 7.7%) or mortality (2.4% vs. 7.7%) compared with early surgery (n=14). Although delayed surgery was associated with shorter postoperative hospital stay (1 vs. 2 days, p=0.029), it prolonged total hospital stay (9 vs. 5 days, p<0.0001).
Conclusions: Delay of LC beyond 72 hours neither increases operative difficulty nor prolongs recovery. It might be more cost effective to schedule patients who could not undergo ‘early urgent’ LC but are responding to conservative treatment for an ‘early interval’ LC within 2 weeks of presentation with AC.
Background: The post-operative acute abdominal complication is one of the most difficult clinical problems facing the surgeon, and it represents a unique challenge for him not only because of the difficulty in making a precise diagnosis but also in the decision for further management . Objective: discuss the post-operative acute abdominal complications requiring re-interventionType of the study: Cross sectional study. Methods : Patients with early post-operative Acute Abdominal complications ( within 30 days from the initial operation ) who required re-intervention were studied prospectively Results :The study included 82 patients 47 of them were females, their age ranging 7-87,Different types of the initial operation were reported,51 %
... Show MoreBackground: 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
Background: Lack of durability of the bond of the dental adhesive systems to tooth structure is one of the most important problems in tooth colored restorative work. This in vitro study was performed to evaluate the effect of 2% chlorhexidine gluconate(CHX) on dentin bond strength by using total etch adhesive system at twenty-four hours and three months of water storage. Material and methods:A flat dentin surface was prepared for forty sound human maxillary premolar teeth which were acid etched with 36% phosphoric acid gel after being divided randomly into four groups of ten teeth each according to storage time and CHX application, theCHX was applied for 60 seconds before adhesive application for groups I and III which were tested after twe
... Show MoreBackground: Postoperative nausea and vomiting (PONV) are one of the most common complaints following laparoscopic cholecystectomy.
Objective: This study was designed to compare the effects of dexamethasone, metoclopramide, and their combination on preventing PONV in patients undergoing laparoscopic cholecystectomy.
Methods: A total of 135 patients enrolled in the study. American Society of Anesthesiologists (ASA) physical status I and II patients were included in this randomized, double blind, placebo-controlled study. Patients were randomly assigned to group A administered 8mg iv dexamethasone, group B received metoclopramide 10 mg, group C received combination of 8mg de
... Show MoreBackground: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.
Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underw
... Show MoreBackground: The healing of a sutured tendon in the hand usually occur with an unwanted amount of scarring that defeat good results. Many variables has been studied over many decades; timing of repair M’as a matter of debate. Zone II is the area where those variables mostly affect the results of treatment.
Objective: To study and evaluate the results of early or delayed repair under the effects of our local variables.
Method: Prospective study of 85 patients, which had flexor tendon repair at zone II by primary repair, delayed primary repair and tendon graft.
Results: Results showed a primary repair ended with better functional results than those with delayed repair and than those with tendon graft. Excellent & good results
Background: Laparoscopic sleeve gastrectomy is becoming one of the most common procedures performed for the treatment of morbidly obese patients in the last few years until now.
Objectives: This type of surgery needs to be evaluated regarding the various techniques used and the possible post-operative complications with the exact methods of treating them.
Patients and methods: A retrospective study was conducted on 240 consecutive morbidly obese patients over a period of 3 years (Feb 2011- Mar 2013) in the Saint Raphael Centre of morbid obesity with an average patient body mass index of 45 (35 - 61). They all underwent LSG, and the decreased weight resulting from surgery was analyzed regarding early and late complications. In 40 of
Summary: Background: The World Health Organization has declared that obesity is a disease of pandemic significance. The number of performed bariatric procedures has rapidly and considerably increased over the past decade. The most frequently performed and best studied procedures are laparoscopic gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Objectve: To provide a critical appraisal of the most important scientific evidence comparing the short term outcomes of these three weight-reduction procedures (laparoscopic gastric banding (LAGB), laparosc