Laparoscopic Cholecystectomy for Acute Cholecystitis: Indication, Risk, and Outcome

2021 ◽  
Vol 8 (06) ◽  
pp. 5508-5513
Author(s):  
Dr. Shiladitya Shil ◽  
Dr. Ashutosh Deb Sarma ◽  
Dr. Md. Alomgir Islam ◽  
Dr. Md. Abdullah-Hel-Baki Abdul ◽  
Dr.Monira Begum
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Prospective Observational Study ◽  
The Other ◽  
Surgical Indication ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
The Mean ◽  
Good Treatment Option

Background: A laparoscopic cholecystectomy is a fundamental approach to treating acute cholecystitis, and the timing of performing this given treatment is associated with clinical outcomes. It is unknown whether surgical indication, risk, and consequences of laparoscopic cholecystectomy for acute cholecystitis differ from those for the chronic form, making it questionable whether urgent laparoscopic cholecystectomy is the best approach even in severe acute cases. Objective: This study aimed to evaluate surgical indication, risk, and outcomes of laparoscopic cholecystectomy for acute cholecystitis. Methods: This prospective observational study was carried out at Bangladesh Medical College Hospital (Uttara Campus) from July 2006 to November 2008. A total of 103 acute cholecystitis patients were observed to evaluate the safety, risk, and outcomes (includes hospital stay, joining to routine daily works) of laparoscopic cholecystectomy. Result: Male and female ratio is 1:4, and the mean age in our series is 47 years. Acute calculas cholecystitis ultra-sonogram feature shows the highest percentage (85.4%) compare to the other four parts. The study also confirmations around 69% did not get any complications, and bleeding was the most frequently observed (16%) complication. The overall outcomes in this research were observed around 75% of total operated patients did not experience any difficulty and said they fit entirely. The other 19% who had some complications include Pain, RTI, Seroma, Jaundice, Cholangitis, Wound infection). Conclusion: Regarding bile duct injury and prolonged complications, laparoscopic surgery is not a very good treatment option for acute cholecystitis.

scholarly journals EARLY LAPAROSCOPIC CHOLECYSTECTOMY

2008 ◽  
Vol 15 (01) ◽  
pp. 162-167
Author(s):  
THAKUR K. HINDUJA ◽  
SHER MOHAMMAD SHAIKH ◽  
MALICK HUSSAIN JALBAN ◽  
Nisar Ahmed Shaikh ◽  
Ishaque Soomro
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Cost Effective ◽  
Abdominal Ultrasound ◽  
Related Complication ◽  
College Hospital ◽  
Female Ratio ◽  
Early Laparoscopic Cholecystectomy ◽  
Medical College ◽  
Surgical Units

To assess the clinical out come of laparoscopic Cholecystectomyfor management of acute cholecystitis and to evaluate its safety, frequency of complications. Design: Observationalstudy. Setting: Surgical Units II and III Of Chandka Medical College Hospital Larkana.. Period: From 01.09.2003 upto 31.12.2007 Patients & Methods: A total of 100 consecutive cases of, acute cholecystitis confirmed subsequentlyby abdominal ultrasound scanning, who were admitted for early laparoscopic cholecystectomy. Results: There wasfemale preponderance with male to Female ratio of 1:4.5. Mean age was 45.75, SD 11.99, and most of patients werereceived with in 24 hours from the onset of symptoms. In 51 patients ultrasound reveals Edematous GB in 24(24%),Empyma 8(8%), Contracted 10(10%), Perforated 5(5%) and Gangrenous GB in 4(4%) while 49(49%) have acutecholecystitis with cholelithiasis. The conversion rate was 6%; The minimum time taken during the procedure was 50minutes. No mortality was reported in this series. Conclusion: Emergency / early cholecystectomy is reliable and safemodality cost effective, and timely surgery with modern conception in themanagement of acute cholecysttitis, becauseof accelerated recovery, negligible wound infection or related complication, and less postoperative pain. So Lap Choleshould be preferred technique now days for the treatment of acute cholecystitis at our Institute.

scholarly journals EARLY LAPAROSCOPIC CHOLECYSTECTOMY;

2008 ◽  
Vol 15 (01) ◽  
pp. 162-167
Author(s):  
THAKUR K. HINDUJA ◽  
SHER MOHAMMAD SHAIKH ◽  
MALICK HUSSAIN JALBANi ◽  
Nisar Ahmed Shaikh ◽  
Ishaque Soomro
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Cost Effective ◽  
Abdominal Ultrasound ◽  
Related Complication ◽  
College Hospital ◽  
Female Ratio ◽  
Early Laparoscopic Cholecystectomy ◽  
Medical College ◽  
Surgical Units

 To assess the clinical out come of laparoscopic Cholecystectomyfor management of acute cholecystitis and to evaluate its safety, frequency of complications. Design: Observationalstudy. Setting: Surgical Units II and III Of Chandka Medical College Hospital Larkana.. Period: From 01.09.2003 upto 31.12.2007 Patients & Methods: A total of 100 consecutive cases of, acute cholecystitis confirmed subsequentlyby abdominal ultrasound scanning, who were admitted for early laparoscopic cholecystectomy. Results: There wasfemale preponderance with male to Female ratio of 1:4.5. Mean age was 45.75, SD 11.99, and most of patients werereceived with in 24 hours from the onset of symptoms. In 51 patients ultrasound reveals Edematous GB in 24(24%),Empyma 8(8%), Contracted 10(10%), Perforated 5(5%) and Gangrenous GB in 4(4%) while 49(49%) have acutecholecystitis with cholelithiasis. The conversion rate was 6%; The minimum time taken during the procedure was 50minutes. No mortality was reported in this series. Conclusion: Emergency / early cholecystectomy is reliable and safemodality cost effective, and timely surgery with modern conception in themanagement of acute cholecysttitis, becauseof accelerated recovery, negligible wound infection or related complication, and less postoperative pain. So Lap Choleshould be preferred technique now days for the treatment of acute cholecystitis at our Institute.  

scholarly journals Primary Retroperitoneal Ganglioneuroma: A Retrospective Cohort Study of 32 Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Jianchun Xiao ◽  
Zixuan Zhao ◽  
Binglu Li ◽  
Taiping Zhang
Keyword(s):  
Growth Pattern ◽  
Clinical Manifestations ◽  
Incomplete Resection ◽  
Radiological Imaging ◽  
College Hospital ◽  
Laboratory Findings ◽  
Female Ratio ◽  
Medical College ◽  
The Mean ◽  
The Masses

Purpose: To investigate the clinical characteristics, diagnosis, differential diagnosis, therapy options, and outcomes of retroperitoneal ganglioneuroma.Methods: In this retrospective study, we collected and analyzed the clinical data of 32 patients diagnosed with retroperitoneal ganglioneuroma and admitted to Peking Union Medical College Hospital from October 2012 to August 2019.Results: Among our 32 cases with retroperitoneal ganglioneuroma, the male-to-female ratio was 1:3 and the mean age was 35. Only 25% of the cases presented with abdominal pain while more than 65% had no specific symptoms. The masses could be found through physical examination in only five patients. Most of the tumors are located near the renal area. They were usually single and displayed an embedded growth pattern with diameters <10 cm, clear borders, and soft texture. For radiological imaging, the majority of tumors demonstrated soft tissue density with mild-to-moderate enhancement on CT imaging and showed hypoecho with moderate blood flow signals in ultrasound. No significantly abnormal laboratory examinations were found in most patients. Of all the 32 patients, 2 chose surveillance after biopsy due to difficulties in operation, while others chose surgical resection. The mean follow-up time was 15.8 months among 26 patients. The tumor remained stable in the surveillance cases. Residual tumors were found in four cases receiving operations with no progress and discomfort. No recurrence was seen in all patients.Conclusions: The retroperitoneal ganglioneuroma is a benign tumor without specific clinical manifestations or significant laboratory findings. Typically, it is shown as low density with a clear border and an embedded growth pattern in radiological imaging. The overall prognosis is good. Surgery is an effective approach with possible severe complications. Incomplete resection or surveillance can be considered for some cases where complete resection is difficult to achieve.

scholarly journals Socio-demographic Characteristics of Patients with Tuberculosis Spine in Bangladesh

2017 ◽  
Vol 3 (1) ◽  
pp. 3-5 ◽  
Author(s):  
Md Shafiul Alam ◽  
Md Abdus Salam ◽  
Tayseer Farzana ◽  
ASM Raushan Newaz ◽  
Md Saiful Islam
Keyword(s):  
Spinal Tuberculosis ◽  
Demographic Characteristics ◽  
Age Group ◽  
College Hospital ◽  
Female Ratio ◽  
High Class ◽  
Medical College ◽  
Class Society ◽  
Male Female Ratio ◽  
The Mean

Background: Spinal tuberculosis is more frequently reported in developing countries.Objective: The purpose of the present study was to see the socio-demographic characteristics of spinal tuberculosis patients.Methodology: This study was carried out in the Department of Neurosurgery, Dhaka Medical College Hospital during the period of January 2002 to December 2004 to elucidate the effectiveness of surgical and conservative treatment of the tuberculosis of the spine. For this purpose, a total number of 50 consecutive cases admitted during the study period with tuberculosis of the spine supported by investigations were included in this study.Result: The mean age of the patients was 25.4 years and ranged from 7 years to 68 years. The highest incidence of tuberculosis of the spine was found in age group between 11 to 20 years and 70% of the patients were under 30 years of age. Incidence of tuberculosis of this spine was more in male (62%) in comparison to female (3 8%) with a male female ratio of 1.63:1. In this study most of the patients came from low class society (66%) followed by middle class (28%) and high class (6%) respectively.Conclusion: Spinal TB more frequently occurs among the young age group with a male predominance.Bangladesh Journal of Infectious Diseases 2016;3(1):3-5

scholarly journals Diaphragmatic Hernia with Atypical Presentation - A Case Series

2014 ◽  
Vol 32 (1) ◽  
pp. 45-50
Author(s):  
SMA Shahid ◽  
MN Ali ◽  
M Ahmed ◽  
SS Islam ◽  
SB Hossain
Keyword(s):  
Diaphragmatic Hernia ◽  
Case Series ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Chest X Ray ◽  
The Mean ◽  
Challenging Situation ◽  
Male To Female ◽  
Diaphragmatic Hernias

Congenital Diaphragmatic Hernia is one of the most challenging diagnosis faced by pediatric surgeons. From the time of its first anatomic description more than 300 years ago, CDH has carried a high mortality rate. We aimed to review patients who presented with hernia of diaphragm during the last six months. In this retrospective study, the medical records of three patients treated for diaphragmatic hernias who were admitted to Rajshahi Medical College Hospital between July 2012 and December 2012 were analyzed. Three patients with age of 45 days to 7 years were included in the study. Male to female ratio was 1:2. All patients had left-sided diaphragmatic hernia. Chest X-ray was obtained from all patients which was diagnostic. One patient needed thoracotomy incision. No patient required mesh repair. The mean hospitalization time was 14 days. There was no postoperative death. Diaphragmatic hernia is an uncommon and challenging situation for the surgeon. Prompt diagnosis and treatment prevent serious morbidity and mortality associated with complications such as gangrene and perforation of herniated organ. DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21050 J Bangladesh Coll Phys Surg 2014; 32: 45-50

scholarly journals Mirizzi syndrome: diagnosis and management of a challenging biliary disease

2019 ◽  
Vol 10 (1) ◽  
pp. 7-11
Author(s):  
Hakim HAN ◽  
SM Quamrul Akhter ◽  
Hashim Rabbi ◽  
Kazi Mazharul Islam ◽  
Md Tuhin Talukder ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Biliary Fistula ◽  
Mirizzi Syndrome ◽  
Medical College Hospital ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Biliary Disease ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College

Background: Mirizzi syndrome is a condition, difficult to diagnose pre-operatively and treat, represent a particular challenge for hepatobiliary surgeons. Furthermore, it increases the risk of intra-operative biliary injury, particularly during laparoscopic cholecystectomy. The aims of this study were to point out some particular aspect of diagnosis and treatment of this condition that will be helpful for the surgeons. Methods: We retrospectively reviewed all records of the patients, surgically treated for Mirizzi syndrome from January 2013 to January 2018 in Dhaka Medical College Hospital, Shaheed Sohrawardy Medical College Hospital and BIRDEM General Hospital. Patients’ presentation, diagnostic methods, treatment and complications were recorded. Results: During the study period, a total of 1320 cholecystectomy were performed, out of which 50 patients were diagnosed with Mirizzi syndrome, representing an incidence rate of 3.78%. Male to female ratio was 0.72:1 and mean age was 54.14 years. When we analyzed the main symptoms in the clinical debut, we found that common features were jaundice (31, 62%), cholangitis (20, 40%) and abdominal pain (22, 44%). Roux en Y hepaticojejunostomy was the treatment of choice and subtotal cholecystectomy were done for 7 cases and laparoscopic cholecystectomy for 2 cases. Mean hospital stay was 4.8±2.9 days. There was no post-operative mortality. Two cases of biliary fistula resolved with conservative management and another case required percutaneous treatment for resolution of an intraperitoneal postoperative collection. Conclusion: Mirizzi syndrome continues to be a disease of difficult diagnosis and treatment. General surgeons without long experience in hepatobiliary surgery should refer the patient to a specialized hepatobiliary surgical center. In most of the cases biliary reconstruction is inevitable. It is important for the surgeons to know the disease and possible intra-operative challenging situations. Birdem Med J 2020; 10(1): 7-11

Obliterative otosclerosis

1991 ◽  
Vol 105 (11) ◽  
pp. 899-900 ◽  
Author(s):  
R. Raman ◽  
John Mathew ◽  
John Idikula
Keyword(s):  
Age At Onset ◽  
Christian Medical College ◽  
Medical College Hospital ◽  
Time Interval ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
The Mean ◽  
Male To Female

AbstractAn analysis of 420 consecutive cases of obliterative otosclerosis seen in the Christian Medical College Hospital, Vellore is presented. The proportion of truly obliterative otosclerosis is 33.09 per cent (139 ears). Our male to female ratio in truly obliterative otosclerosis is 1.48:1, while in the non-obliterative group it was 1.34:1. The mean age at onset in the obliterative group was 19.14 while in the non-oblierative group it was 25.60. This is statistically (P<0.001). The age at presentation was 25.90 in the obliterative group while in non-obliterative group it was 30.86; this is also statistically significant (P<0.001). However the time interval between the age at onset and the age at presentation is not statistically significant.

scholarly journals A clinical study of mode of delivery and perinatal outcome in iligohydramnios

2017 ◽  
Vol 6 (6) ◽  
pp. 2212
Author(s):  
U. S. Hangarga ◽  
V. G. Kulkarni ◽  
. Nikitha
Keyword(s):  
Perinatal Outcome ◽  
Maternal Age ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Research Centre ◽  
Maternal Complications ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: To evaluate intrapartum sequale of sonographically diagnosed Oligohydrominos such as rate of caesarean section, fetal distress and condition of the new born.Methods: This Prospective observational study was conducted in the department of obstetrics and Gynecology, Navodaya Medical College Hospital and Research Centre between June 2015 to December 2016. The antenatal women with gestational age more than 34 weeks and above, attending our OPD or labor room were included in this study.Results: A total of 140 cases of Oligohydromnias were selected for present study and outcome were assessed. The mean maternal age is 24.42 years. 32.14% cases have delivered vaginally, 67.82% patients went for caesarean sections, 10.7% of babies needed NICU care and 1 was still birth. No adverse maternal complications were observed during the study.Conclusions: Oligohydromnia is one of the frequent complications during labor. The risk of muconium staining of liquor, intrapartum fetal distress, operative delivery and NICU admissions are more in Oligohydromnia cases.

Utility of Tolonium Chloride Rinse in the Diagnosis of Oral Cancer

2020 ◽  
Vol 26 (1) ◽  
pp. 11-17
Author(s):  
Md Kamruzzaman ◽  
Kazi Nurjahan ◽  
AS Gazi Sharifuddin ◽  
SK Ballav
Keyword(s):  
Developing Countries ◽  
Oral Cancer ◽  
Prospective Study ◽  
Diagnostic Delay ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Biopsy Report ◽  
Patient Side ◽  
Tolonium Chloride

Background: Oral cancer burden in developing countries is huge. In Bangladesh and India incidence were 10.6% and 10.4% respectively on 2018. At the same time worldwide incident was only 2%. Majority patients present at advanced stage and their survival rate is poor. Diagnostic delay from patient side and health delivery system side is significantly longer and it is more in developing countries. Like other malignancy early diagnosis can save a lot of these patient. Methods: This prospective study was carried out in Khulna Medical College Hospital from July 2017 to July 2019. Patients who will meet the criteria for this prospective study and capable and willing to give informed consent were enrolled. 20 second rinse/gargle with 10ml of 1% Tolonium chloride solution was done. Biopsy were taken from stained lesion, biopsy report were compared with TC stained lesions. Results: Out of 1650 patients in our outdoor department for various problem and only 30 cases were selected for this study according to selection criteria. Of 30 patients, 18 (60%) were male and 12 (40%) were female. The male-to-female ratio was 3:2. It was found that the sensitivity of 1% Tolonium Chloride rinse for oral precancer and cancer detection was 83.33%, whereas the specificity was 84.21%. Conclusion: Tolonium chloride rinse is a good screening test for oral cancer diagnosis with sensitivity 83.33% and specificity 84.21%. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 11-17

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

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