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Article
Sero-bacteriological detection of bacteria in the gall bladder, blood and stool of patients having cholecystectomy

Authors: Zen Al-Abdeen Abdul-Allah زين العابدين عبد العزيز عبد الله --- Ansaam M. Hamdoon انسام محمد حمدون
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2008 Volume: 34 Issue: 2 Pages: 118-125
Publisher: Mosul University جامعة الموصل

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Abstract

Objectives: 1- To identify the bacteria from the gall bladder and stool samples taken during cholecystectomy of patients with acute, and chronic cholecystitis of calculus and acalculus types. 2- To use serological agglutination tests for the diagnosis of typhoid and brucellosis cholecystitis.3- To find out the antibiogram of the isolated bacteria from the different cases.
Methods: A prospective case series study was conducted at Al-Jumhori Teaching Hospital, and Ninevah and Al-Zahrawi Private Hospitals during the period from the 1st of October 2003 to the 30th of June 2004. A total of 150 patients undergoing cholecystectomy (134 females and 16 males)were studied. From each patient samples were collected from the gall bladder (bile, tissue biopsy and stone if present),blood for serological tests and stool (from 69/150 patients).
Results: Among the gall bladder samples, 101/150 (67.3%) cases showed bacterial growth, the remaining 49 (32.7%) cases had no growth. The bacterial growth was seen among 83.3% and 64.3% of acute and chronic cholecystitis respectively. A single agent per sample was detected in 62.4% of the cases, whereas mixed growth was identified in the remaining 37.6%. The gram-negative bacteria were predominant and represented 86.7% of the isolates,while gram-positive ones were 13.3%. The most common aerobic bacteria isolated were E. coli (19.3%), while anaerobes were detected in only 5.3% of the isolates. The stool cultures showed similar microorganisms to those identified in the gall bladder samples in 74% of cases. In acute cholecyctitis all the gram-negative bacteria were sensitive to ciprofloxacin followed by ceftriaxone (96.5%) and gentamycin (96.5%). In chronic cholecystitis the most effective drug was ciprofloxacin (93.7%) followed by amikacin (82.2%). In both acute and chronic cholecystitis the least effective antibiotic was ampicillin.Typhoid cholecystitis was detected among four cases only, while brucellosis cholecystitis was not observed.
Conclusions: The bacteria causing acute and chronic types of cholecystitis are similar and predominantly are gram-negative bacilli. The intestinal origin of these microorganisms suggests ascending infection from the intestine to the biliary tract. Ciprofloxacin is the most effective drug against the isolated bacteria.
Keywords: cholecystitis, typhoid- cholecystitis, brucellosis-cholecystitis.

الهدف من الدراسة : للتعرف على الجراثيم الموجودة في عينات المرارة والبراز المأخوذة خلال عملية استئصال المرارة من المرضى المصابين بأنواع التهاب المرارة الحاد أو المزمن الحصوي وغير الحصوي.2-اجراء فحوصات التلازن المصلية لتشخيص التهاب المرارة الناتج عن حمى التيفوئيد والحمى المتموجة (المالطية).3- لإيجاد نسبة الحساسية لمختلف أنواع المضادات الحيوية للجراثيم المعزولة من حالات التهاب المرارة المختلفة. التصميم:دراسة مستقبلية لحالات متسلسلة.موقع الدراسة: جمعت عينات هذه الدراسة من المستشفى الجمهوري التعليمي ومستشفى نينوى والزهراوي الأهليتان للفترة من الأول من تشرين الأول عام 2003 م وحتى الثلاثين من حزيران عام 2004م.مواد وطرق العمل :شملت الدراسة 150 مريضاً أجريت لهم عملية استئصال المرارة (134 إناث و 16 ذكور). أخذت عينات من كل مريض تضمنت المرارة (عصارة الصفراء، وعينة من نسيج المرارة ومن الحصى إن وجدت) ، والدم لإجراءالفحوصات المصلية والبراز لـ69/150 مريضا فقطً. نتائج الدراسة : أظهرت النتائج نمواً للجراثيم في 101 من اصل 150 عينة (67.3%) ، وفي الحالات الـ 49 المتبقية (32.7%) لم يلاحظ نموا" للجراثيم في العينات المزروعة . لوحظ نموا للجراثيم في الأوساط المزروعة في 83.3%و64.3% من حالات التهاب المرارة الحاد والمزمن على التتابع. تم عزل نوع واحد من الجراثيم في 62.4 % من العينات المزروعة. بينما لوحظ نموٌّ لعدة أنواع من الجراثيم في بقية الحالات (37.6%) . كانت الجراثيم السالبة لصبغة كرام المتسيدة وكونت 86.7% من الجراثيم المعزولة ، بينما كونت الجراثيم الموجبة لصبغة كرام 13.3% فقط . أكثر الجراثيم الهوائية المعزولة شيوعاً كانت الشريشيات القولونية وكونت (19.3%) بينما الجراثيم اللاهوائية وجدت في 5.3% من الجراثيم المعزولة. أظهرت نتائج زرع البراز جراثيم مشابهة لتلك التي وجدت في العينات المأخوذة من المرارة في 74% من الحالات. في حالات التهاب المرارة الحاد كانت جميع الجراثيم السالبة لصبغة كرام حساسة للسبروفلوكساسين ، يليه السيفتراياكسون والجنتامايسين (96.5%)لكليهما . أما في حالات التهاب المرارة المزمن فان المضاد الحيوي الأكثر فاعلية كان السبروفلوكساسين (93.7%) يتبعه الاميكاسين (82.2%) . وفي كلا حالتي التهاب المرارة (الحاد والمزمن) كان المضاد الحيوي الأقل فاعلية هو الأمبسلين. التهاب المرارة التايفوئيدي لوحظ في اربع حالات بينما لم تعزل جراثيم الحمى المتموجة من حالات التهاب المرارة.الاستنتاجات : إن الجراثيم المسببة لنوعي التهاب المرارة الحاد والمزمن متشابهة وغالبيتها من الجراثيم السالبة لصبغة كرام. إن المصدر المعوي لهذه الجراثيم يشير الى صعود الالتهاب من الأمعاء إلى القنوات الصفراوية. السايبروفلوكساسين كان الأكثر فاعلية ضد الجراثيم المسببة للأنواع المختلفة من التهاب المرارة.


Article
Outcome of laparoscopic cholecystectomy in acute and chronic cholecystitis

Author: Omar S. Khattab
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 3 Pages: 262-265
Publisher: Baghdad University جامعة بغداد

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Abstract

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 teaching hospital, Baghdad. Evaluation of all patients admitted with symptomatic gall bladder disease, who underwent laparoscopic cholecystectomy were included in this study. They were classified as group A (having acute cholecystitis) and group B (having chronic cholecystitis), The diagnosis of AC was based on clinical, ultrasonographic, and operative finding; also histological diagnosis.
Results: A total of 197 patients. 46 (23%) had acute cholecystitis (group A) while 151 patients (76.6%) had chronic cholecystitis (group B). In group A, Gall bladder decompression was required in 4 (8.7%) patients. One patient (2.2%) had wound infection, and one patient (2.2%) developed a subhepatic biliary collection. While epigastric port hernia occurs in one patient (2.2%). In group B, One patient (0.7%) had wound infection, and one patient (0.7%) had umbilical port hernia. Conversion rate was 3(6.5%) for group A and 0% for group B. There was no procedure related mortality in either group. The hospital stay (6-24 hours) was the same for both groups (group A; mean 9.13±6.89 hours, group B; mean 15.77±8.99 hours).
Conclusion: laparoscopic cholecystectomy is safe in all patients presented with symptomatic gall bladder disease.


Article
The benefit and feasibility of early laparoscopic cholecystectomy

Author: Haqqi I. Razzouki
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2014 Volume: 13 Issue: 2 Pages: 40-45
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Acute cholecystitis is a common disease. The best managementin early cases is surgical, but the optimal timing for surgery remainscontroversial. With advances and increased experience in laparoscopicsurgery, laparoscopic cholecystectomy is increasingly being used in themanagement of acute cholecystitis.Aims: To determine the best time to operate in acute cholecytitis (early vs.delayed) and to compare the results of laparoscopic approach with those ofopen surgery in the treatment of acute cholecystitis .Patients and Methods: This was a prospective study done at al‐Yarmoukteaching hospital, Baghdad from Sep. 1st 2012 to Sep. 2nd 2013. All patientsadmitted with a proved diagnosis of acute cholecystitis were included. Thepatients were divided into two groups, the first group had earlycholecystectomy, laparoscopic (LC) or open (OC). The second group wastreated conservatively and delayed cholecystectomy was done. Detailedclinical, investigative and imaging data were recorded. The details of theoperative findings, procedures and early post‐operative complications, weredocumented.Results: There were 146 patients, 82.2% female and 17.8% male. The mean agewas 40±2 years. Early surgery was done for 32.8% of patients, 58.4% as alaparoscopic procedure, and 41.6% as an open procedure. Delayedcholecystectomy was done in 67.2% of cases. In the early group,the difficultywas minimal in 27.2%, moderate in 39.5%, marked in 25 % and very difficult withconversion done in 8.3%. Early complications were noticed in 4.2% in the earlyLC group, and 8.3% in the early OC. For delayed LC, 8.1% had earlycomplications vs. 6.1% for delayed OC.Conclusions: Early laparoscopic cholecystectomy is a safe and feasibleapproach to the management of acute cholecystitis.


Article
Serum levels of several types of cytokines associated with Chronic Cholecystitis in Basrah /south of Iraq.
تقدير مستوى المدورات اللمفاوية المصاحبة لالتهاب المرارة في البصرة /جنوب العراق

Author: Awatif H. Issa & Muthena M. Muthena عواطف حميد عيس و مثنى محمد مثنى
Journal: basrah journal of science البصرة للعلوم ISSN: 18140343 Year: 2014 Volume: 32 Issue: 2B micro conf Pages: 248-280
Publisher: Basrah University جامعة البصرة

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Abstract

Acute cholecystits is an acute inflammation of the gallbladder. A Total of 52 Cholecystectomy patients from a Al- Sadar Teaching hospital and 52 healthy volunteers were enrolled . Blood specimen collected by sterile container from both . The serum levels of pro-inflammatory cytokines (IL-1, TNF-α & IL-6) were significantly increased in gallstone patients sera comparing to healthy controls at (p<0.05) .While anti-inflammatory cytokine IL-4 concentrations in gallstone patients sera showed significant reduced comparing to healthy controls at (p<0.05). And regulator cytokine IL-17 concentrations in gallstone patients sera showed not significant reduced comparing to healthy controls at (p<0.05), . Finally IgG concentrations in gallstone patients sera showed significant elevation comparing to healthy controls at (p<0.05).The elevation of pro-inflammatory cytokines including (IL-1 , IL-6 & TNF-α) indicated the presence of inflammatory response associated with gallstone. The reduction of anti-inflammatory cytokine (IL-4) and regulator cytokine (IL-17) indicated the presence of immune predisposition in patients for gallstone.

يعد التهاب المرارة من الالتهابات الحادة ..جمعت عينات دم من 52 مريض يخضع للعملية (استأصال المرارة) في مستشفى الصدر التعليمي و52 اصحاء متطوعين لغرض السيطرة. جمعت عينات الدم في قناني معقمه. كان مستوى المدورات اللمفاوية البادئة للالتهاب والمتمثله (IL-1, TNF-α & IL-6)مرتفعة وبفارق معنوي عن السيطرة عند مستوى الاهمية (p<0.05) بينما المضادة للالتهاب والمتمثله بال IL-4منخفضة وبفارق معنوي عن امصال السيطرة أما ال IL-7 و الذي يعد من المدورات اللمفاوية المنظمة منخفظا ولكن ليس بفارق معنوي ( P< 0.05). كما ارتفع مستوى IgG في امصال المرضى مقارنة بالسيطره.


Article
Early Laparoscopic Versus OpenCholecystectomy for Acute Cholecystitis

Author: Mumtaz K. H. AL-Nasir
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 76-81
Publisher: Baghdad University جامعة بغداد

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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.
Key Words: Acute cholecystitis– Conversion rate – Laparoscopic .


Article
EARLY LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS AT AL-KADHIMIYA TEACHING HOSPITAL

Authors: Osama M. Alabid اسامه محمد علي العبد --- Hassan A. Hassan حسن احمد حسن
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2014 Volume: 12 Issue: 1 Pages: 37-43
Publisher: Al-Nahrain University جامعة النهرين

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Background:Despite the well-accepted success of laparoscopic cholecystectomy (LC) in the elective treatment of symptomatic gallstone, the safety and the efficacy of this technique has been subjected to some debate in the setting of acute cholecystitis (AC).Objective:To evaluate our institution’s experience with early LC and to evaluate the safety and effectiveness of LC in the treatment of AC.Methods:Eighty nine patients were diagnosed as having AC based on the clinical, laboratory and ultrasound findings; 80 patients were divided randomly into two equal groups.Group 1 included 40 patients who had early LC for AC within one week from onset of the symptoms and group 2 included 40 patients who had late LC around 6 weeks from onset of symptoms as interval LC after conservative treatment. Results:No significant difference in the conversion rate (in early group 8 patients (20%) versus delayed group 6 patients (15%). Complication rate was insignificant (in early group 4 patients (10%) versus delayed group 3 patients (7.5%). The delayed group had a significantly shorter operative time (early group = 128±53.5 min versus delayed group = 107±50.1 min) and significantly shorter postoperative stay (early = 2.4±3.2 days versus delay = 1.4±1.4 days). The early group had a significantly shorter total hospital stay (early = 5.5±3.1 days versus delay = 8.5±4.5 days). The male gender had a significant higher conversion rate in both groups.Conclusion:Early LC can be performed safely in most patients with AC and it is considered as effective treatment, allows significantly shorter total hospital stay with no significant differences in conversion rate or complications compared with delayed LC, in the hands of a safe and well trained surgeon.Keywords:Early laparoscopic cholecystectomy, acute cholecystitis.


Article
LAPAROSCOPIC CHOLECYSTECTOMY: ATHREE-YEAR RETROSPECTIVE STUDY
استئصال المرارة بالمنظار: دراسة استعادية لمدة ثلاث سنوات

Author: DILDAR HAJI MUSA دلدار حاجي موسى
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2018 Volume: 12 Issue: 2 Pages: 81-91
Publisher: University of Dohuk جامعة دهوك

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Abstract

ABSTRACTBackground and Objectives: Laparoscopic cholecystectomy has made a revolution in themanagement of symptomatic gallstone diseases. It has been widely accepted as a surgicalintervention for gallstone and cholecystitis. The spectrum of complications following thepresentation of this new minimally invasive surgical technique has been changed.In thepresent retrospective study, immediate, early, and late laparoscopy242 patients underwent laparoscopic cholecystectomy for symptomatic gallstone diseasesover three years were critically and clinically evaluated.Subject and Method: In a retrospective study, the complications of 242 patients under wentlaparoscopic cholecystectomy were reviewed clinically and critically.Results From January 2015 to January 2018, 242 patientscholecystectomy for the symptomatic gallstone disease. The mean age of the patients was40.12 year. Six patients were found with immediate bleeding, two caseswith postcholangitis due to passed stone, two patients with late port site hernia, and one case with subhepatic collection (abscess), and three cases developed port site infection. The conversion toopen surgery was found in three patients (1.24%) only.Conclusions: The surgeons need to select their patients carefully, equip themselves with thefor a safe laparoscopic cholecystectomy

الخلفية والأهداف: استئصال المرارة بالمنظار قد أحدث ثورة في السيطرة على أمراض المرارة العرضية. لقد تم قبولاستئصال المرارة بالمنظارعلى نطاق واسع كتدخل جراحي في حالات حصوات المرارة والتهاب المرارة. تم تغيير سلسلةالمضاعفات بعد تقديم هذه التقنية الجراحية الجديدة الأقل اجتياحا. في الدراسة الاستعادية الحالية، تم تقيم المضاعفات الأنية والمبكرة والمتأخره المتعلقه باستعمال المنظار في 242مريض يعاني من حصوات المرارة العرضي تم تنظيريهم وخضعهم لأستصال المرارة على مدى ثلاث سنوات تم تقييمهابشكل نقدي وسريريا.طرق البحث: في دراسة استعادية ، تم استعراض المضاعفات السريريا الخطيرة ل 242 مريض استئصلت مراراتهمبالمنظار لأمراض الحصوة المرارية.النتائج: من يناير 2015 إلى يناير 2018 ، خضع 242 مريض لأستئصال المرارة بالمنظار لأمراض الحصوة المرارية.كان متوسط عمر المرضى 12,40 سنة.تم العثور على ستة مرضى مع نزف طفيف على الفور، حالتين التهاب الأقنية الصفراوية بعد العملية بسبب الحجر الذيتم تمريره، واثنين من المرضى الذين يعانون من فتق متأخر في موقع القصطرة البوابية، وحالة واحدة تطورت الى خراجتحت الكبد و ثلاث حالات التهاب جروح فتحات الناظور.الاستنتاجات: يحتاج الجراحون إلى اختيار مرضاهم بعناية، وتجهيز أنفسهم بالمعرفة المطلوبة لأجراء النموذجي المرتبطفي المضاعفات ، واختيار أفضل و أمن طريقة لعلاج المرارة وأستئصالها بالمنظار.


Article
An ‘early interval ' (Delayed Urgent) laparoscopic cholecystectomy for acute cholecystitis: evidence to support a safe surgical procedure.

Author: Imad F. Sakran عماد فارس سكران
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 2 Pages: 142-146
Publisher: Baghdad University جامعة بغداد

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Abstract

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’ cholecystectomyObjectives: 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. There were no conversions and no bile duct injuries. Delayed surgery (n=36) neither prolonged operating time (90 vs. 85 minutes) nor increased operative morbidity (9.7% vs. 7.7%) or mortality (2.4% vs. 7.7%) compared with early surgery (n=14). Although delayed surgery was associated with shorter postoperative hospital stay (1 vs. 2 days, p=0.029), it prolonged total hospital stay (9 vs. 5 days, p<0.0001).
Conclusions: Delay of LC beyond 72 hours neither increases operative difficulty nor prolongs recovery. It might be more cost effective to schedule patients who could not undergo ‘early urgent’ LC but are responding to conservative treatment for an ‘early interval’ LC within 2 weeks of presentation with


Article
Early and late Biliary Complications of Laparoscopic Cholecystectomy in Acute Cholecystitis

Author: Omar Salem Khattab عمر سالم خطاب
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2011 Volume: 7 Issue: 2 Pages: 131-136
Publisher: Baghdad University جامعة بغداد

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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 for laparoscopic cholecystectomy; they were divided into two groups, (group 1) including patients with acute cholecystitis; (group 2) including patients with severe acute cholecystitis. Results: 306 patients were admitted for laparoscopic cholecystectomy, 71 (23.2%) of them with acute cholecystitis and was involved in this study; they were divided into two groups, (group 1) patients with acute cholecystitis 61(85.9%), (group 2) patients with severe acute cholecystitis 10 (14%); including gangrenous gallbladder 3(30%), and empyematous gallbladder 7(70%). Patients in group 2 were significantly older than in group 1. Female sex was more significant in group 1, while male sex was more significant in group. There was no procedure related mortality. Conclusion: laparoscopic cholecystectomy for acute cholecystitis is safe and associated with a low morbidity, mortality, and a low conversion rate.


Article
Histopathological Analysis of Cholecystectomy Biopsies
التحليل النسيجي المرضي لخزع المرارة المستاصلة جراحيا

Author: Kassim Fawzi Abdulkareem قاسم فوزي عبد الكريم
Journal: JOURNAL OF THI-QAR SCIENCE مجلة علوم ذي قار ISSN: 19918690 Year: 2012 Volume: 3 Issue: 3 Pages: 54-58
Publisher: Thi-Qar University جامعة ذي قار

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Abstract:The present study includes 304 laparoscopic cholecystectomy biopsies which were processed forpathological examination at the pathology laboratory of Basrah general hospital during 2010. Chroniccholecystitis was the most common pathological diagnosis comprising 80.7 % in males and 93.1 % infemales, while gallstones were found in 74 % of the examined bladders, most of which were chroniccholecystitis.Chronic cholecystites were characterized by significantly thin walls. The mean age was around40 years for both sexes. Carcinoma of the bladder was the least pathological diagnosis (0.3%).

الخلاصة:اشتمل البحث على 403 خزعة نسيجية للم ا ررة استؤصلت ج ا رحيا وأرسلت للمختبر المركزي للأم ا رض في مستشفى البصرة العام خلالعام 0000 . وجد بالفحص النسيجي لخزع الم ا ررة بان التهاب الم ا ررة المزمن هو أكثر الحالات المشخصة تك ا ر ا ر. كما وجد بان 43 % منالحالات احتوت على حصى الم ا ررة وان اغلبها مصاب بالتهاب الم ا ررة المزمن الذي تميز بجدار ذو سمك قليل. بلغ متوسط العمر للمرضى.)% المشمولين 30 عاما وللجنسين وأكثرهم من الإناث. شكل سرطان الم ا ررة اقل الإصابات المشخصة بالفحص النسيجي) 0,4

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