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Register a new userLaparoscopic Management of Acute Calculous Cholecystitis
تدبير التهاب المرارة الحادّ الحصوي بالتنظير
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شملت الدراسة (163) حالة استئصال مرارة بالتنظير باستطباب التهاب مرارة حادّ حصوي، في الفترة من 1/1/2010 و لغاية 31/12/2013 و ذلك في قسم الجراحة بمشفى الأسد الجامعي باللاذقية. كانت نسبة الذكور (24.5 %) و الإناث (75.5 %) و نسبة الإناث إلى الذكور (1:3.08). أغلب مرضى دراستنا (53.4 %) كانوا بعمر بين (21-40) سنة. أكثر الأعراض توارداً في دراستنا كانت الألم (92.6 %)، و الحمّى (74.8 %)، و الغثيان و القياء (72.4 %). أجري إيكو البطن عند المرضى جميعهم. أكثر المضاعفات أثناء استئصال المرارة بالتنظير كانت تمزّق المرارة و سقوط الحصيّات في البطن (3.7%)، و بعد العمل الجراحي كان التسرّب الصفراوي (8.6 %). نسبة التحويل من الجراحة التنظيرية إلى الجراحة المفتوحة كانت (7.4 %). (50.9 %) من مرضانا أجري لهم التداخل الجراحي خلال الـ 72 ساعة الأولى من الدخول إلى المشفى و (49.1 %) تمّ التداخل الجراحي بعد الـ 72 من الدخول إلى المشفى. متوسّط مدّة العمل الجراحي في دراستنا (72) دقيقة. متوسّط مدّة الإقامة بالمشفى (1.7) يوم.
This study included (163) patients admitted to the department of Surgery in Al-Assad university hospital at Lattakia , between 1/1/2010 and 31/12/2013. They all had Laparoscopic cholecystectomy due to acute cholecystolithiasis. The male patients composed (24.5%), and the female patients composed (75.5%) and the ratio of females to males was (1:3.08). In our study the age of most patients (53.4 %) was between (21-40) years. The more frequent clinical features was pain (92.6%) , fever (74.8%) and (nausea + vomiting) (72.4%). Ultrasound abdomen was done in (100%). The most intra – operative complication was perforation of gall bladder and spilled stones (3.7%) and post – operative complication was spilled bile. The conversion rate from Laparoscopic cholecystectomy to open method was (7.4%). cholecystectomy was done in (50.9%) in the first 72 hours of hospitalization and was done in (49.1 %) after the 72 hours of hospitalization. The median operating time was (72) minutes . The mean stay being (1.7) days.
Artificial intelligence review:
Research summary
تتناول هذه الدراسة تدبير التهاب المرارة الحاد الحصوي باستخدام التنظير، حيث شملت 163 حالة استئصال مرارة بالتنظير في مشفى الأسد الجامعي باللاذقية خلال الفترة من 1/1/2010 حتى 31/12/2013. كانت نسبة الإناث إلى الذكور 3.08:1، وأغلب المرضى كانوا في الفئة العمرية بين 21-40 سنة. أكثر الأعراض شيوعاً كانت الألم (92.6%)، الحمى (74.8%)، والغثيان والقيء (72.4%). أجري تصوير بالموجات فوق الصوتية لجميع المرضى. كانت المضاعفات الأكثر شيوعاً أثناء الجراحة تمزق المرارة وسقوط الحصيات في البطن (3.7%)، وبعد الجراحة كان التسرب الصفراوي (8.6%). نسبة التحويل من الجراحة التنظيرية إلى الجراحة المفتوحة كانت 7.4%. متوسط مدة العمل الجراحي كان 72 دقيقة، ومتوسط مدة الإقامة بالمشفى 1.7 يوم. الدراسة تهدف إلى تقييم فعالية الجراحة التنظيرية في تدبير التهاب المرارة الحاد الحصوي مقارنة بالجراحة التقليدية.
Critical review
دراسة نقدية: تقدم الدراسة معلومات قيمة حول فعالية الجراحة التنظيرية في تدبير التهاب المرارة الحاد الحصوي، ومع ذلك، يمكن تحسينها من خلال تضمين تحليل أعمق للعوامل التي تؤثر على نجاح الجراحة التنظيرية مثل خبرة الجراحين والتقنيات المستخدمة. كما يمكن أن تكون الدراسة أكثر شمولية إذا تضمنت مقارنة مباشرة مع نتائج الجراحة التقليدية في نفس الفترة الزمنية. بالإضافة إلى ذلك، يمكن تحسين الدراسة من خلال تقديم توصيات واضحة بناءً على النتائج المستخلصة.
Questions related to the research
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ما هي نسبة الإناث إلى الذكور في الدراسة؟
نسبة الإناث إلى الذكور في الدراسة هي 3.08:1.
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ما هي الأعراض الأكثر شيوعاً بين المرضى في الدراسة؟
الأعراض الأكثر شيوعاً كانت الألم (92.6%)، الحمى (74.8%)، والغثيان والقيء (72.4%).
-
ما هي نسبة التحويل من الجراحة التنظيرية إلى الجراحة المفتوحة؟
نسبة التحويل من الجراحة التنظيرية إلى الجراحة المفتوحة كانت 7.4%.
-
ما هو متوسط مدة الإقامة بالمشفى بعد الجراحة؟
متوسط مدة الإقامة بالمشفى بعد الجراحة كان 1.7 يوم.
References used
ZINNER, M.J. 1997 – Maingot's abdomind operations . 10th edition, prentice Hall international . Inc . London . U. K
MULHOLLAND, M.W.; LILLEMOE, K.D.; DOHERTY, G.M.; MAIER, R.V.; UPCHURCH, G.R. Greenfield's Surgery: SCIENTIFIC PRINCIPLES AND PRACTICE. 4th Edition Copyright 2006 © Lippincott Williams & Wilkins; Chapter 62. Calculous Biliary Disease; P:979-999
BRUNICARDI, F. C.; ANDERSON, D.K.; BILLIAR, T.R. DUNN, D.L. HUNTER, J.G. MATTEWS, J.B. POLLOCK, R .E.; Schwartz's principles of Surgery. The Mc Graw-Hill Education. 10th Edition 2015; Part II. Specific Considerations. Chapter 32. Gallbladder and the Extrahepatic Biliary System
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This study was carried out in the department of anesthesia and reanimation at
ALASSAD , TishreenUniversity Hospitals ,Lattakia,Syria,during the year 2014 - 2015,and
included 60 patients of either sex (20 – 60 years of age ) under going elective lap
aroscopic
cholecystectomy.
Patients were divided into two groups:
Patients of group G received oral gabapentin 600 mg 2 hours before inducation of
anesthesia , while patients in group p did not receive any drug before the surgery.
The goal of the study is studying The effects of gabapentin premedication on
hemodynamic stability during laparoscopic cholecystectomy
Results : there were significantly hemodynamic stability in patients of group G as
compared to group p.
Conclusion : Gabapentin premedication provided perioperative hemodynamic
stability during laparoscopic cholecystectomy.
Background& Objective: Management of CSF rhinorrhea by an effective and less traumatic endoscopic tans-nasal approach in comparison with traditional open craniotomy one. Objective: To study cases of CSF rhinorrhea and to evaluate the results of Endos
copic trans-nasal repair and failure rates.
Materials & Methods: Retrospective study of 34 cases (first main group) of meningeal nasal fistula admitted to Al Moassate university hospital between 5.2004 - 5.2009 in addition to three cases in which the fistula had occurred during an endoscopic sinus surgery (second secondary group).
Results: In the first group the main presenting complain was persistent or intermittent clear watery rhinorrhea in 30 patients (88.23%), history of repeated Meningitis in 4 patients (11.76%) and rhinorrhea and one episode of meningitis in one patients (2.94%).A history of head trauma was detected in 20 patients (58.82%), nasal surgery in 4 patients (11.76%), where no history of head trauma or nasal surgery was found in 10 patients (29.41%). The fistula situated in the roof of the ethmoid sinus in 28 patients (79.41%), roof or lateral wall of sphenoid sinus in 4 patients(11.76%), and in the roof of both ethmoid and sphenoid sinuses in tow patients(5.88%). The fistula was closed by endoscopic trans-nasal approach with fascia latta in 31 patients (83.78%), fascia of rectus abdominalis in one patient and with the mucoperostium of contra-lateral inferior turbinate in 5 patients (13.51%). Follow-up was for 12-43 months. Recurrence has occurred in 10 patients (27.02%) in a form of recurrence of watery rhinorrhea or recurrence of meningitis or both of them. Second endoscopic trans-nasal intervention had done in 8 of
them, second recurrence occurred in 3 patients. Thus the overall success rate was (91.42%).
Conclusion: Endoscopic trans-nasal approach is an effective way to repair the meningeal nasal fistulas with low morbidity and mortality rate in comparison with the traditional open neurosurgery approach.
The research was conducted on 60 patients, checking in the Department of Obstetrics
and Gynecology at the Assad University Hospital in Latakia, complaining of infertility(an
initial or secondary) between2011-2013
A satisfactory detailed story of t
he couple was taken with extra focus on the clinical
symptoms of polycysticovary of the wife (obesity, hirsutism, irregular menstruation,
infertility) and overlooking other feminine or masculine causes of infertility. In addition to
the calibration of Fsh, Lh, free testosterone, and ultrasound imaging of the uterus and
ovaries,
a perforation was performed on the ovaries by laparoscopic surgery. Patients were
checked for a year. This check up showed healthy pregnancy in 27 patients by 45%, but
this didn't work for 31 patients by 51.66%. In addition, 2 cases of abortion3.33% were
reported. . The study showed that age, duration of infertility and the rate of LH had an
effect on the success of the laparoscopic ovarian drilling process with patients of
Polycystic ovary.
Overview: Otitis media with effusion (OME) is the most common type of Otitis
media (OM), especially in young children between 2-5 years. The main cause of this type
is the decrease in ventilation of the middle ear, which creates purulent fluid. Sev
eral factors
play a significant role in etiology as Eustachian tube dysfunction, adenoid hypertrophy and
allergically causes, in addition to the immunological and metabolic disorders. The main
symptom of (OME) is poor hearing, which may lead to permanent hearing loss if
untreated. The traditional treatment of (OME) has not been successful in quite a number of
cases.
Aim of study: Evaluation of the effect of bite opening technique in management of
chronic otitis media with effusion in children.
Materials and Methods:This clinical study included 30 cases of otitis media with
effusion. Ages of patients were between 2 - 10 years old, which were managed at the
Auditory Clinics at Al-Assad University Hospital in Lattakia.
laparoscopic cholecystectomy has many features that make it preferable to open
surgery with a low incidence of complications.
The study was conducted on 877 patients who underwent laparoscopic
cholecystectomy at Al-Assad and Tishreen hospitals in
the period 2010-2017
The surgical method used and the reasons for conversion to open surgery were
studied in addition to the complications occurring during or after the surgery in terms of
occurrence rate and method of management of complications and the results of this
management.
The average age of patients was 46 years, the proportion of females was 64.5%, the
mean surgical time was 45 minutes.
The ratio of conversion to open surgery was 2.05% and the most common cause was
severe inflammation, "unclear calot`s triangle" and suspicion of malignancy.
Partial laparoscopic cholecystectomy was performed in 1.36% of cases and
peroperative complications occurred in 0.34% of cases and postoperative complications in
2.16% of cases.
Analysis of the results revealed that the rates of conversion for open surgery and the
incidence of complications are within the internationally accepted rates and that the results
of management of complications were satisfactory and consistent with the methods used
globally to manage complications.
We concluded that this surgery is safe and its complications are rare. We recommend
applying it in our hospitals . We have suggested some recommendations that can reduce
the complications of this surgery.
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