Sonar guided mini-laparotomy cholecystectomy versus laparoscopic cholecystectomy: a prospective, randomized study

To analyze outcomes after open small-incision surgery [minilaparotomy] guided by ultrasonography and laparoscopic surgery for gallstone disease. This study was a randomized trial comparing laparoscopic cholecystectomy [LC] to sonar guided minilaparotomy cholecystectomy [SMC] at El-Minia University Hospital and carried out in 60 patients from March 2005 to February 2006. LC was a routine procedure at El-Minia University hospital, whereas SMC was introduced recently. Of 60 patients, 30 were randomized to LC and 30 to SMC. The groups were well matched for age and sex. Median operating times were 100 and 48 minutes for LC and SMC, respectively. Median hospital stay was nearly equal in both groups. Intraoperative complications were less frequent in the SMC group, but there was no difference in the postoperative complication rate between the groups. Costs for operation, other health care costs, costs due to sick-leave and total costs were calculated and proved to be significantly higher in LC group. There was no bile duct injury in each group and no deaths. Operating time was longer and costs were higher for LC compared with SMC. Further analyses of LC versus SMC are necessary regarding surgical training, surgical outcome, and health economy

Risk factors and clinical presentation of brucellosis in Al-Jahra hospital [1997-1999]

To analyze the clinical and demographic features of brucella patients hospitalized at the Jahra Hospital [JH] between January 1997 and December 1999. Variables were obtained directly from medical records. A total of 115 patients were reviewed, re p resenting 0.9% of all medical admissions; down fro m 10% in the mid-80s. Almost all cases had a history of contact with cattle and/or ingestion of raw milk. Male Bangladeshi shepherds were the most predominantly re p resented group among our cases. The median age of patients was 32 years. The season of infection culminated in the spring and was lowest in the winter The median stay in hospital was six days, and was longest for Bangladeshis and Kuwaitis compared to other nationalities. Serious complications occurred in only two patients and resolved without sequel. Tw o other patients relapsed and required a second course of antibiotics. Conclusions: The remarkable decline in the incidence of brucellosis in Al-Jahra is very likely due to changes in diet and animal husbandry. Shepherds are still at high risk, and consideration to their socio-economic vulnerability and harsh work conditions must be addressed to further reduce the incidence of brucellosis in Kuwait