Single-Session Treatment of Cholecysto-Choledocholithiasis: Totally Laparoscopic versus Laparo-Endoscopic
Mostafa Mohamoud Sayed,
Ayman Kamal,
Abdallah Mohamed Taha,
Mahmoud Abdelhameid,
Ahmed Mohamed Ali Abdallah,
Zein Sayed
Issue:
Volume 5, Issue 5, October 2017
Pages:
72-78
Received:
2 July 2017
Accepted:
11 July 2017
Published:
13 September 2017
Abstract: Background: This study details Assiut and South Valley universities experience in treating combined gall bladder and common bile duct stones in a single session, either with Endoscopic Retrograde Cholangio-Pancreatography (ERCP) for Common Bile Duct (CBD) stone extraction followed by laparoscopic cholecystectomy (LC), or totally laparoscopic treatment. Patients and methods: In this prospective randomized study, 46 consecutive patients with confirmed cholecysto-choledocholithiasis were randomized to 2 groups. Group (A) included 24 patients treated with single-session ERCP for CBD stone extraction and laparoscopic cholecystectomy [ERCP-LC]. Group (B) included 22 patients treated with laparoscopic CBD exploration and laparoscopic cholecystectomy [LCBDE-LC]. Demographic data, operative time, CBD clearance success rate, short term complications and duration of hospital stay were recorded. Results: Patients included 28 females and 18 males with mean age of 42.1 ± 12.1 years (range 17 – 71 years). In 22/24 patients (91.7%) ERCP-LC was done successfully. Mean operative time was 105 ± 19.1 minutes (50-150 min.). No intra-operative complications occurred. Early post-operative complications occurred in 3 patients (12.5%). Mean hospital stay was 2.1 ± 0. 91 days (1-6 days). In the other group, LCBDE-LC was performed successfully in 22/22 patients (100%). Mean operative time was 145 ± 23 minutes (100-180 min.). Minor intra-operative complications (bleeding) occurred in 2/22 cases (9%). Minor early post-operative complications (bile leak, ileus, bleeding) occurred in 4/22 patients (18%). Mean hospital stay was 2.8 ± 0.83 days (2-7 days). Conclusion: Single session ERCP-LC and LCBDE-LC procedures for management of cholecysto-choledocholithiasis are feasible, safe, and effective and have comparable outcome regarding success rate, peri-operative complications. ERCP-LC has statistically significant less operative time and less hospital stay.
Abstract: Background: This study details Assiut and South Valley universities experience in treating combined gall bladder and common bile duct stones in a single session, either with Endoscopic Retrograde Cholangio-Pancreatography (ERCP) for Common Bile Duct (CBD) stone extraction followed by laparoscopic cholecystectomy (LC), or totally laparoscopic treatm...
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Acupuncture Treatment for Psoriasis Present on the Soles
Jihe Zhu,
Blagica Arsovska,
Kristina Kozovsk
Issue:
Volume 5, Issue 5, October 2017
Pages:
79-81
Received:
22 August 2017
Accepted:
4 September 2017
Published:
9 October 2017
Abstract: Psoriasis is a chronic autoimmune skin disorder. Psoriasis manifests as itchy and sore plaques on the skin, mostly located on the knees, elbows, scalp, palms or soles. Psoriasis affect people in all age groups, equally male and female. It is controlled by the type of white blood cells - T cells, which protect the body against infections and disease. In Traditional Chinese Medicine (TCM) psoriasis is considered as a Blood heat disorder. The treated patient is a 43 years old woman with psoriasis manifested on the both feet (soles). The psoriasis was present more than 20 years, but the last year patient’s soles were in the worst condition. The patient was treated with acupuncture treatment, in our clinic for TCM and acupuncture. The positive outcome was achieved after 13 treatments. Treatments were done once weekly, indoor, with duration of 35-40 minutes. The aim of the treatment was to correct the Yin defect, therefore were treated points located on the meridians of Spleen, Liver, Kidney, Ren Mai and Ashi (trigger) points on the soles. Acupuncture as part of the TCM is very helpful treatment in treating psoriasis as it can reduce the inflammation, itching and pain and improve the overall health of the patient.
Abstract: Psoriasis is a chronic autoimmune skin disorder. Psoriasis manifests as itchy and sore plaques on the skin, mostly located on the knees, elbows, scalp, palms or soles. Psoriasis affect people in all age groups, equally male and female. It is controlled by the type of white blood cells - T cells, which protect the body against infections and disease...
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Pattern and Outcome of Paediatric Surgical Admissions in a New Tertiary Hospital in Northwestern Nigeria
Kache Stephen Akau,
Sale Danjuma,
Ajah Jonathan Luka,
Yusuf Nuhu,
Omisakin Oluleke Olatunde,
Makama Jerry Godfrey
Issue:
Volume 5, Issue 5, October 2017
Pages:
82-85
Received:
24 May 2017
Accepted:
17 August 2017
Published:
19 October 2017
Abstract: The pattern and outcome of pediatric surgical admissions may be crucial to policy formulation in a new tertiary hospital. This study reports the pattern and outcome of pediatric surgical admissions in Northwestern Nigeria. This is a retrospective review of all medical records of patients admitted with pediatric surgical pathologies over a 14 months period. Data was extracted from the admission records and case notes of children admitted in the hospital during the study period. Information obtained included the patients’ age, sex, diagnosis, duration of admission and outcome. The data obtained was analyzed using SPSS version 15.0 for Windows. There were 191 pediatric surgical admissions representing 12.5% of the total pediatric admissions with a mean age of 71 months and a male to female ratio of 1.2:1 (M 105: F86). Sixty percent of the patients were admitted to female surgical ward, others were admitted to neonatal intensive care unit, male surgical ward, pediatric medical ward and emergency pediatric unit due to shortage of manpower and lack of pediatric surgical facilities. The most common diagnostic categories were congenital anomalies 35.1% (67/191), trauma 30.9% (59/191) and surgical infections 29.8% (57/191). Eighty percent of our patients did well and were discharged. However, we recorded a mortality rate of 9.9%. Our report shows that wide spectrums of pediatric surgical conditions are seen in our hospital with congenital anomalies being the most common. Most of our patients were treated and discharged.
Abstract: The pattern and outcome of pediatric surgical admissions may be crucial to policy formulation in a new tertiary hospital. This study reports the pattern and outcome of pediatric surgical admissions in Northwestern Nigeria. This is a retrospective review of all medical records of patients admitted with pediatric surgical pathologies over a 14 months...
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