Background: Acute cholecystitis is common surgical
problem, which was treated previously by conservative
treatment .Later early open has been introduced as an
alternative to interval for treatment of acute cholecystitis.
Early open was found to be a safe, successful with
comparable postoperative complication rate. With the
advent of laparoscopy laparoscopic have been used for
chronic cholecystitis and became the first line of
treatment. New reports have shown that laparoscopic can
be used as an alternative to open for surgical treatment of
acute cholecystitis.
Objectives: to compare the success, safety of early
laparoscopic versus early open as a primary treatment of
acute cholecystitis.
Methods: out of 68 patients were treated for clinical
acute cholecystitis between January 2002 and February
2004 in the department of surgery, at Al – Kindy teaching
hospital. A total of 62 patients underwent early for acute
cholecystitis as soon as possible after diagnosis. The
preferred preoperative imaging technique was ultrasound.
30 (48.3%) of the operations were attempted
laparoscopically, whereas the remaining 32 patients
(51.7%) underwent initial open .
Results: The mean operative time for the open cases
was 75 minutes versus 60 minutes for the laparoscopic
group. There was no perioperative mortality in either
group. The incidence of conversion to open was 10% (3
patients). Surgical complications related to laparoscopic
and open occurred in 2 (6.6%) and 3 (9.3%) cases,
respectively. There was no difference between the open
and laparoscopic groups in regard to the major
postoperative complications.
Conclusion: The current study shows that early
(whether performed by open or laparoscopically) is a
safe and effective treatment for acute cholecystitis. Low
conversion rates can be maintained with strict guidelines
for appropriate patient selection, adequate experience,
and proper laparoscopic technique.
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
... Show MoreBackground: laparoscopic cholccystectomy (LC) gained a wide acceptance as treatment of choice for acute cholccyslitis (AC) as early in 72 hours of admission or after interval of 8-12 weeks after the patient treated by medical treatment.
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: 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
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
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. Ther
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: Laparoscopic surgery for
appendicitis is now a well established and
advanced method of performing general surgical
procedures.
Objectives: To compare the outcome of
laparoscopic and open appendectomies in terms
of operative time, analgesic requirement,
postoperative complications, hospital stay, return
to normal activity and condition of scar.
Methods: This prospective study was carried
out from 1stMay 2008-1st January 2010, involving
110 patients (45 male and 65 female) with
features suggestive of acute appendicitis were
divided into 45 patients laparoscopic
appendectomy (LA) group and 65 patients open
appendectomy (OA) group, after taking informed
consent. LA was done with the
Background: laparoscopic cholecystectomy (LC) is getting popularity for the treating of symptomatic gall bladder disease; conversion from laparoscopic to open cholecystectomy (OC) is also common.
Objective : To find out the prevalence of causes, risk factors of conversion from LC to OC among patient suffering from gall bladder disease, and to explore the most common causes of conversion from laparoscopic to open cholecystectomy.
Methods: This prospective study was conducted in the department of general surgery at Alkindy teaching hospital from first of January 2016 to the end of December 2017 .Nine hundred twenty patient were included. Patient age, gender, his
... Show MoreBackground: 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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