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Article
15- PANCEREATIC HYDATID AS A CAUSE OF EPIGASTRIC MASS, A CASE REPORT.....

Author: MUSHTAQ CH ABU-ALHAIL
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2008 Volume: 14 Issue: 2 Pages: 88
Publisher: Basrah University جامعة البصرة

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Abstract

Primary hydatid cyst in the corpus of pancreas is a rare. A woman of 35 Years old came with atwo-month history of epigastric Pain, occasional vomiting and an epigastric mass. On Physicalexamination the vital sign were normal. The only Positive sign besides ahard epigastric masswas mild tenderness. Ultrasonography and CT Showed a cyst at the Corpus of the Pancreas4X5cm Diameter. The Patient under went midline laparotomy and an isolated hydatid cyst of thePancreas was found. This is a rare manifestation of this disease.

Keywords

HYDATID


Article
NATURAL ORIFICE TRANSLUMENAL ENDOSCOPIC SURGERY (NOTES) A CRITICAL APPRAISAL

Authors: Jasim D Saud --- Mushtaq Ch Abu-AlHail
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2010 Volume: 16 Issue: 2 Pages: 8-11
Publisher: Basrah University جامعة البصرة

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Abstract


Article
10- SPILLED GALL STONES DURING LAPAROSCOPIC CHOLECYSTECTOMY : A PROSPECTIVE STUDY

Authors: Mushtaq Ch. Abu-Alhail --- Mazin A Abdulla --- Jasim D Saud
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2011 Volume: 17 Issue: 1 Pages: 65
Publisher: Basrah University جامعة البصرة

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Abstract

Jasim D Saud#, Mazin A Abdulla@ & Mushtaq Ch. Abu-Alhail**#MBChB, CABS, Specialist Surgeon, Basrah General Hospital, Basrah, Iraq. @MBChB, CABS,Consultant Surgeon, Department of Surgery, College of Medicine, University of Basrah, Basrah, Iraq.ABSTRACTThis study assesses the impact of spilled gall stones during laparoscopic cholecystectomy (LC)and it's clinically significant complications resulting from stones left in the peritoneum.This is a prospective analysis of laparoscopic cholecystectomies performed at The SurgicalUnit in Basrah General Hospital from 1st January 2006 to 31st December 2010. There were 678patients in the study who underwent LC. The inclusion criteria for LC were: patients of all agesand both genders, symptomatic gallstone disease, recurrent attack while waiting for interval LC,normal values of blood complete picture & liver function tests and ultrasound examination ofabdomen demonstrating gallstone disease.There were 73 cases of gallbladder perforation, i.e. a frequency of 10.7%. In 34 of thesepatients gallstones spillage also occurred in a frequency of 5%. An effort was made in eachcase to remove the spilled stones laparoscopically but in 25 patients unretrieved stones wereleft (frequency of 3.6%). Eight patients (1.17%) developed complications, one patient developedileus which was thought to be the result of irritation from a gallstone that had been shown on USexamination. The free fluid in the Douglas pouch resolved with medical management. Twopatients developed sub-hepatic abscess, presenting with right hypochondrial & shoulder tip painand fever post operatively; which confirmed by abdominal sonograph, one patient respondedwell to medical treatment while the other one required ultrasound guided drainage and broadspectrumantibiotics. Three patients developed epigastric port site infection; two were treatedsuccessfully by daily wound care and appropriate antibiotics after culture and sensitivity. Onedeveloped persistent epigastric sinus, and a gallstone was retrieved on exploration. Twopatients developed sub-hepatic and right sub-phrenic abscess respectively in the seventh postoperative day and required open drainage. There was no mortality and long-term morbidity.In conclusion, complications arising from spillage of gall stones during laparoscopiccholecystectomy are rare. They can present months after the cholecystectomy with septiccomplications. The patients should be informed preoperatively that spillage of bile andgallstones are possible. The surgeon should take utmost care to prevent spillage of stones andattempt to remove all visible stones at the time of surgery. If spillage occurred it should berecorded clearly in the operative notes and such patients should be kept under close follow upto aid in the early diagnosis of later complications. There is no indication for routine conversionto open surgery.


Article
SUBCUTICULAR WITH INTERRUPTED SUTURING; TECHNIQUE FOR ABDOMINAL WOUND CLOSURE

Authors: Mazin H AL-Hawaz --- , Mushtaq CH Abu-alhail --- Sabah S Jabir
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2010 Volume: 16 Issue: 2 Pages: 55-61
Publisher: Basrah University جامعة البصرة

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Abstract

Closure of the wound after surgery is a routine procedure and one of the first things that asurgeon in training should learn. A surgeon will successfully closes a thousand of woundsduring his career, but the problem of wound infection remains challenging.This study was conducted to compare between two methods of skin closure which aresubcuticular alone and combined subcuticular with interrupted suturing regarding; woundinfection, cosmesis &speed of wound closure.Between December 2006 and October 2009, two hundred and two patients were admitted inBasrah General Hospital, department of surgery. They underwent elective abdominal operationand were randomized into two groups, group A (abdominal skin closure by subcuticular suturingonly) and group B (combined subcuticular with interrupted suturing). There were 102 cases inthe subcuticular group, 50 cases of them were males and 52 cases were females, while ingroup B there were 100 cases,42 cases of them were males and 58 cases were females. Meanage was 38.9 (range 4-66) for group A and 41.6 (range 8-67) for group B. The mean BMI was25.2 (range 17.4-34.8) for group A and 26.4 (range 18.7-39) for group B.Results: Wound infection: The total number of early wound infection for the six �weeks follow �up period was 12 cases (11.7%) for the subcuticular (group A),and 4 cases (4%) for thecombined (group B)_(P=0.036). Cosmoses: There was no significant difference in cosmeticresult in both groups. Speed of wound closure: Combined (group B) closure was accomplishedat significantly faster rate (mean 35.6 sec/cm) than subcuticular (group A) closure (mean46.8sec/cm) (p=0.001). Conclusion: From this study we conclude that the choice of techniquefor wound closure did not affect the final cosmetic outcome of the wound but the incidence ofpostoperative wound infection significantly reduced by combined subcuticular and interruptedsuturing. The closure of wound is rapid in combined group than in subcuticular group alone.

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