Laparoscopic fundoplication in the treatment of gastro-oesophageal reflux disease. an initial experience in Zagazig and Minia University Hospitals

To study the role of laparoscopic surgery in the treatment of chronic gastro-oesophageal reflux disease [GORD], fourteen cases were admitted to the department of surgery of Zagazig and Minia University Hospitals. All patients were selected after failure of medical treatment, full investigations especially motility studies were done. All cases were examined endoscopicaly and for 24 hours pH-monitoring. All cases were operated by the same team of authors. Nissen fundoplication was done. The mean operative time was 120 +/- 12 minutes. There was no mortality recorded in our study. There was marked reduction in the postoperative complications in comparison to the open surgery, and there was significant improvement in the reflux problem. In conclusion laparoscopic fundoplication is a well promising technique that can effectively relieve symptoms of GORD with minimal morbidity and mortality as well as the mild postoperative pain. Short hospital stay and other benefits of laparoscopic surgery. However long term follow up is needed for proper evaluation

Modified pancreatico-gastrostomy after pylorus preserving pancreatico-duodenectomy for cancer head of pancreas

The leakage of pancreatic juice is one of the most serious complications after pancreatico-duodenectomy. In an attempt to lessen the incidence of this complication, we performed a. modified pancreatico-gastrostomy after pancreatico-duodenectomy in 31 patients. The technique was made by implantation of the pancreatic remnant with pancreatic duct stent into the posterior gastric wall after the performing of figure of 8 sutures opposite to each other at the inferior and the superior borders of the pancreas. One layer of the invaginating anastomosis was performed between the pancreas and the posterior gastric wall. The following parameters were assisted: mortality; morbidity; length of the hospitalization and duration of the nasogastric tube and drainage. The range of the patient admission was ranged from 9 to 24 days. The new technique in the present study has proved to be applicable and has many advantages than the previously used methods since, the morbidity and the mortality rates were reduced, no pancreatic leakage was observed in all patients and no delaying gastric emptying was recorded during the hospital period for all cases

Carcinoma of pancreas: an ultrastructural study

20 cases of adenocarcinoma of pancreas were included in this study. They were 13 men and 7 women with age range 36-70 years. These cases were operated in department of General Surgery, Zagazig University.Histopathologic diagnosis revealed 6 cases were well differentiated and 12 cases were moderate while 2 cases were poorly differentiated. E/M study of all cases showed that the most common affected organelle was the mitochondria and the nuclear change were essential as a landmark of malignancy. Light microscopic differentiation between pancreatic well differentiated adenocarcinoma and other pancreatic lesions as chronic pancreatitis was difficult in some cases. So E/M examination is an important modality in diagnosis of such cases

Role of interleukin 6 level in post splenectomized thalassemic patients in Zagazig University Hospitals

Interleukin-6 [IL-6] plays an important role in megakaryocytopoiesis and platelet production.Thrombocytosis and inappropriate blood clotting occur postsplenectomy, this rebound phenomenon is more common following splenectomy for myeloproliferative disorders. So this study was done to assess levels of interleukin 6 in these patients. Levels of interleukin 6 were studied in 34 nonsplenectomized thalassemic patients [thal/nonsplen], 23 post-splenectomized thaIassemic patients [thal. I postsplen.], 13 splenectomized non thalassemic [non thal. /postsplenectomized] and 18 normal control by enzyme linked immunosorbent assay method. Serum IL-6 concentration in thaI. I postsplenectomized was significantly increased when compared with thal/nonsplenectomized and control volunteers [3.55 +/- 2. 47 pglml vs 2.38 +/- 2.31 pg/ml, P = 0.036 and 3.55 +/- 2.47 pg /ml vs 2.66 + 0.45 pg/ml, P = 0.028 respectively]. There was a trend towards increasing of cytokine levels in thal. / postsplen with higher platelet count although no correlation was observed. This study addresses the possible role of IL-6 in the pathogenesis of reactive thrombocytosis in thal/postsplenectomy

Effect of unilateral nephrectomy on the healthy kidney in the rabbit [an experimental study]

The effect of unilateral nephrectomy on the contralateral kidney were studied functionally and histologically. Twenty normal adult rabbits were used. They were divided into 5 groups, control [1] and experimental from 2 to 5.The nephrectomized animals were sacrificed at regular time, 3 weeks interval between each group after nephrectomy. In group [2], 3 weeks after nephrectomy, the glomeruli showed mild reduction in the size of the glomerular tufts and mild widening of urinary spaces as well as slight elevation of nitrogenous urea. At the ElM level the glomeruli showed marked vaculations, the foot processes became short and thick and the basement membrane started to lose its regularlity in addition to disappearance of some capillary walls. The previous changes were obvious and progressed in correspondence with the period of sacrificed animals after nephrectomy.In addition to oedematous basement membrane, reduction in the number of glomeruli as well as mitochondrial degenerations. These findings suggested that there were marked hypertrophic changes within the glomeruli and marked increase in the level of nitrogenous urea and creatinine