ABSTRACT
Introduction: Biliary Atresia is a fibroobliterativedisorder of the intra andextrahepatic bile ducts in infancy, which isgoing progressively cholestatic liver disease.The failed Kasaiportoenterostomy requiresliver transplantation. The goal of this studyis to show the outcome of Kasai operation,recent improvement and correlation the datato overseas.Methods and Materials: This study wasconducted in the department of generalsurgery of National Center for Maternal andChild Health of Mongolia between 2010 and2016 on a total of 66 infancies with biliaryatresia.Results: Patient diagnosed with biliaryatresia, which performed Kasai operationwithin first 2 months the outcome is verygood early and late post-operation period.There were 3 patients with 10 year survival, 4patients with 5-10 year and 28 patients with5 year survival after Kasai operation. The mostcomport age for liver transplantation is 1 yearlater after Kasai operation in Mongolia. Livertransplantation programme is necessary forMongolian pediatric surgery, and we thoughtour team was assembled.Conclusion: The children with biliary atresiaperform the Kasai operation within 2 monthsthe outcome is very good. Children with biliaryatresia often experience long wait times fortransplant unless exception points are grantedto reflect severity of disease.In Mongolia livertransplantation done in 2 child.
ABSTRACT
Introduction: In our hospital we didfirst laparoscopic surgery in October 2013with doctors from Samsung Medical Center,Seoul, Korea. In NCMCH we did about 3000operations per year, and about 400 of themtakes inguinal hernia. Bilateral and unilateralbig hernias has a lot of complications,like swelling, recurrence etc. Goals andobjectives:comparison between LNAR andstandard open technique of hernia repair.Calculate the outcome, hospital stay,recurrence, complications.Materials and Methods: We describeour technique and experience with thelaparoscopic needle-assisted repair of inguinalhernia (LNAR). We report retrospectively 42cases (hernias) from September 2014 toDecember 2015. We have 2 groups. In firstgroup we did standard open hernia repair in23 (54,7%)cases, in second group we didLNAR in 19 (45,3%) cases. Hernia repairis accomplished with a one port needleassistedtechnique. After identification of apatent processusvaginalis, the internal ringis encircled in an extraperitoneal plane usinga 22G-Touhy needle for placement of apurse-string suture, tied extracorporally, andburied beneath the skin. The technique wasstandardized for second group cases. Inguinalhernias were laparoscopically repaired in19patients (16 boys and 3 girls) age range1year to 16 years. All 19 cases had bilateralrepair. Mean operating time for bilateral was45 min. No complications in second group.For the first group we had 18 boys and 5girls same age range. Mean operating time1hour 20min.8 minor complications wereidentified(8 swelling) and 1 recurrence. Postoperativedata show our technique is safewith no complication. No recurrence.Results: First group: we had 18 boysand 5 girls,age range 1year to 16 years.Mean operating time1 hour 20min. 8 minorcomplications were identified (8 swelling)and 1 recurrence. Second group: we had16 boys and 3 girls, age range 1year to 16years. All 19 cases had bilateral repair. Meanoperating time for bilateral was 45 min. Nocomplications.Conclusions: In our technique meantime was shorter than in standard opentechnique. Post-operative data show ourtechnique is safe with no complication.No recurrence. Furthermore, laparoscopyobjectively identifies asymptomatic or occultcontralateral defect, uses a smaller incision,and eliminates dissection of the cordstructures potentially reducing the risk ofcord injury.