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The Impact of Prophylactic Dexamethasone, Metoclopramide or both on Nausea and Vomiting After Laparoscopic Cholecystectomy

Background: 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 dexamethasone and 10 mg metoclopramide and group D received 10 cc normal saline.The incidence of PONV, mean visual analog pain scores, request for analgesia, side effects , and well-being score were recorded during the first 24 h postoperatively.

Results: Total incidence of PONV during 24 hr was 24% in the dexamethasone group (group A), 47% in the metoclopramide group (group B), 15% in the dexamethasone plus metoclopramide group (group C) and 61% in the placebo group (group D).

None of the dexamethasone plus metoclopramide group patients required other antiemetic (B6 ample iv.), as compared with one patient in dexamethasone group, three patients in the metoclopramide group and five patients in the placebo group. Pain scores, the time to the first request for analgesia, and side effects were similar across the study groups.

Conclusions: Dexamethasone and the combination of dexamethasone plus metoclopramide were more effective in preventing PONV than metoclopramide and placebo.

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Publication Date
Mon Jul 01 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Comparison between the effect of propofol(TIVA)and inhalational anesthesia(halothane)on early postoperative nausea and vomiting.

Background: Postoperative nausea and vomiting (PONV) is a highly observed feature postoperatively. The type of surgery, the technique, medication, duration of anesthesia, and various patient factors all contribute to the condition.
Objectives: To evaluate and compare the effect of halothane and propofol on early postoperative nausea and vomiting
Patients and methods: A randomized clinical trial was conducted on 80 patients who scheduled for hernioplasty during the 1st of October/ 2010 to the 5th of February/ 2012 in Baghdad Teaching Hospital / Medical City Complex / Baghdad / Iraq. All patients were allocated into two groups randomly (40 patients each), group(A) were received 1-2 mg/Kg propofol as induction and used for maintenance

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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
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
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 Apr 30 2021
Journal Name
Al-kindy College Medical Journal
Outcome of Perforated Gallbadder during Laparoscopic Cholecystectomy

Background: Laparoscopic cholecystectomy (LC) has become the standard treatment for symptomatic cholelithiasis. Bile duct injury and accidental gallbladder perforation with spillage of bile and stone are common complications of LC. This study was carried out to assess the early complications of gallbladder perforation during LC, and identify the risk factor of that perforation.

Objectives: to evaluate the early complications which may occur after the perforation of the gallbladder during laparoscopic cholecystectomy and to determine the risk factors which are associated with the perforation of the gall bladder. 

Subjects and methods: A prospective comparative study o

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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
Sun Oct 03 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Outcome of laparoscopic cholecystectomy in acute and chronic cholecystitis.

Background: laparoscopic cholecystectomy is standard treatment in gallbladder disease. Acute cholecystitis has been relative contraindication of laparoscopic cholecystectomy. With the
accumulation of experience in laparoscopic surgery, laparoscopic cholecystectomy is being gradually applied for the treatment of acute cholecystitis
Objective: to evaluate and compare the outcome of laparoscopic cholecystectomy in acute and chronic cholecystitis in terms of complications, conversion rates, reason of conversion, need for special modifications of the operative technique, and hospital stay.
Methods: A prospective study done Between April 2007 and January 2010, in the department of general surgery, medical city teac

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Effect of early laparoscopic Cholecystectomy in Acute Cholecystitis

Background: Laparoscopic cholecystectomy (LC) has become the treatment of choice for elective cholecystectomy.Objectives: To evaluate the safety and feasibility of early LC for AC and to compare the results with delayed LC.Methods: A prospective study done from April 2011 to October 2013, 88 patients with diagnosis of AC were divided randomly into two groups according to the mode of treatment; (early group n=40) treated by early LC within first 72 hours or (delayed group, n=48) initial conservative treatment for 4-6 weeks, followed by delayed LC.Results: There was no difference between the two groups (early & delayed LC), operating time (early 80min, delayed70min), conversion rate (early 7.5%, delayed 6.25%),postoperative complicatio

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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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