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Article
Laparoscopic Management of Hepatic Hydatid Cysts in Kerbala

Author: Abdulrazzak Kalaf Hassan
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2015 Volume: 8 Issue: 1 Pages: 2085-2092
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Hydatid disease is a common problem in Iraq and Surgery is themainstay of treatment. This is a prospective study of those patients with liver Hydatidcyst who were managed surgically at Al-Hussain Medical City in Kerbala for a period of one and half year from January 2013 to June 2014.Aim of the study: The aim of this study was to discuss the clinical presentations, diagnoses, and laparoscopic surgical treatment of liver hydatid cysts in comparison with other studies .Methods: forty patients were enrolled in the study, data collected: preoperative assessment, type of treatment and postoperative follow-up until their discharge from our hospital.The diagnosis was based on clinical examination, plain X-Ray, U/S & CT scan, MRI and MRCP.Results and discussion: hydatid cyst forms the commonest space occupying lesion in the liver. The recurrent form of the disease was found in 12 patients (30% ) and the multiple liver hydatid found in 16 patients (40%). This relatively high incidence of recurrence and multiplicity of the disease indicate high prevalence of such pathology in our areas.24 patients (60%) operated laparoscopically and 16 patients (40%) were operated by traditional opened method.The surgical treatment of hydatid cyst were in form of: Excision and external drainage in 32 patients (80%), excision and omentoplasty in 8 patients (20%).Post-operative complications included: Wound infection in 5 patients (12.5%), respiratory tract infection in 4 patients (10%), urinary tract infection in 3 patients (7.5 %), persistent drainage through the tube drain in 3 patients (7.5%), abscess collection in the residual cavity in 2 patients (5%) and persistent obstruction of the common bile duct in 1 patient (2.5%).Overall morbidity was 45% of our patients. No mortality was recorded.Conclusions: laparoscopic treatment of the hepatic hydatid cyst is a new method with great advantages and minimal disadvantage and we highly recommend to assess any patient for laparoscopic treatment.


Article
Povidone Iodine and Hypertonic Saline Induced Sclerosing Cholangitis in Hepatic Hydatid Cysts Surgery

Author: Abdulrazzak Kalaf Hassan
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2017 Volume: 10 Issue: 2 Pages: 2680-2686
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Surgery is the treatment of choice for hepatic hydatid disease but surgical treatment carry the risk of recurrence if we do not use a proper scolicidal agent and may convert patient with solitary hepatic hydatid cyst to patient with many incurable cysts. The ideal scolicidal agent should kill vital scolices, and not have local or systemic adverse effect, and not toxic to bile duct. Yet, there is no ideal scolicidal agent involving such effects. One of the important serious complications after instillation of scolicidal agents is sclerosing cholangitis.Aim: to assess the risk and severity of povidone iodine and hypertonic saline induced sclerosing cholangitis in guinea pigs.Materials and methods: In this study we used twenty guinea pigs which were divided into two equal groups. In the first group 0.3 ml10% povidone iodine was injected to the biliary tree after clamping then released after five minutes and second group, 0.3 ml 20% hypertonic saline was used.Four months later on the pig was euthanized by ether and three biopsies taken from the liver and sent for histopathological examination. Afterwards, the liver, gall bladder, the common bile duct and the duodenum were excised in one piece and immediately transferred for cholangiography. Two X-ray films were taken for each specimen in lateral and antero-posterior view after contrast material injection. Results: in povidone iodine group 8 animals (80%) had sclerosing cholangitis while in hypertonic saline group only 2 animals (20%) had sclerosing cholangitis. This difference between the two groups was statistically significant. Conclusions: Usage of 10% povidone iodine as a protoscolicidal agent carry high risk of sclerosing cholangitis.


Article
•Early versus Delayed (Interval) Laparoscopic Cholecystectomy For Acute cholecystitis

Authors: Rawaa Mumtaz --- Abdulrazzak Kalaf Hassan --- Anees Khaleel Nile
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2011 Volume: 4 no 2 Issue: 10 Pages: 1162-1169
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: The surgical management of patients presenting with acute cholecystitis remains controversial.The aim of this study was to evaluate the safety and feasibility of urgent laparoscopic cholecystectomy during the “index” (acute) admission with acute cholecystitis, and to compare with a policy of delayed (interval) cholecystectomy.Methods: Between December 2009 and March 2011, 120 patients who had undergone laparoscopic cholecystectomy. Sixty patients underwent surgery during the index admission (group I). Sixty patients were assigned to initial conservative treatment followed by delayed laparoscopic cholecystectomy (group II).Results: The cholecystectomy for acute group took longer operative time, needed more modification of the procedure used. It had comparable rate of complication, conversion rate and a shorter hospital stay than delayed group.Conclusions: Laparoscopic cholecystectomy during the index admission with acute cholecystitis can be performed safely and successfully.

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Article
Role of Laparoscope in Abdominal Trauma

Authors: Abdulrazzak kalaf Hassan --- Hussein M. Ali Diaa Zainny
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2019 Volume: 12 Issue: 1 Pages: 4068-4076
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Use of laparoscopy in trauma is in general limited for diagnostic purposes; we aim to evaluate the therapeutic role of laparoscopic surgery in trauma patients. Laparoscope could be safe and effective in the treatment of patients with abdominal trauma.Aims of the Study: To identify the following:1.Benefits of Laparoscope in Abdominal Trauma. 2.Contraindications for Laparoscope in Trauma Patients. 3.Indications for conversion (from laparoscopic to open approach).Patient and methods: Forty patients with abdominal trauma, whether penetrating or blunt who was admitted to the casualty unit in Imam Hussein Medical City in The Holy Karbala City from Jan 2016 to June 2016 and were diagnosed as cases of acute abdomen by clinical examination base some were in shock state and unstable, admitted immediately to theatre, laparotomy was done to them. Other cases in shock, but corrected undergone surgery for different causes, some of them undergone purely laparoscopic interference by laparoscopic device under the name (KARL STORZ—ENDOSKOPE), other patients undergone conversion for different causes.Results: Forty were included in a prospective study who were undergone surgical intervention either in the form of traditional laparotomy or diagnostic laparoscopy eight (20%) of them undergone exclusive laparoscopic interference while nine (22.5%) undergone conversion, other twenty- three (57.5%) undergone open approach.Conclusions: From our study, we concluded that:1.A laparoscope is an important tool in the management of blunt abdominal trauma. 2.A laparoscope is a good preventive measure of nontherapeutic laparotomies. 3.It’s an important measure in diagnosing and even treating diaphragmatic injuries.4.Traumatic bowel injuries can be diagnosed and even treated by the laparoscope 5.The presence of profuse hemorrhage make continue on the laparoscopic approach is non judges.

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