[Evaluation of relationship between complications of cholecystitis and gender based on findings during laparoscopic cholecystectomy in educational hospitals of Ahvaz]

Gallstone disease is one of the commonest diseases in GI tract which can be presented as acute or chronic cholecystitis. The severity of cholecystitis is depended on different factors. The aim of this study was to find if there is a difference in the development of complications following laparoscopic cholecystectomy among males and females. The medical evidences of complications among patients who underwent laparoscopic cholecystectomy since 2001 to 2006 were analyzed. A total of 101 patients were evaluated. The following complications were recorded: empyema in 6 patients [5.9%] [5 male: 1 female], perforation in 2 patients [1.9%] [2 males: 0 female], gangrene [13.9%] [11 males: 3 females], conversion to open cholecystectomy in 9 patients [8.9%] [all were males], acute cholecystitis in 47 patients [46.5%] [32 males: 15 females] and chronic cholecystitis in 54 patients [53.3%] [9 males: 45 female]. According to these results, the incidence of complications and severity of cholecystitis is more common in male gender. Whereas chronic cholecystitis is more common in females. Probability of conversion to open cholecystectomy is more common among male gender. Finally, according to this study, male gender is an important risk factor which can increase the severity of cholecystitis

Factors responsible for fistula failure in hemodialysis patients

There are multiple factors in failure of Arterio Venous Fistula [AVF] in patients with Chronic Renal Failure [CRF] that require periodic hemodialysis. Out of technical errors, hypotension, site of insertion, size of vessels, diabetes and atherosclerosis are the common causes of failure in AVFs. In this study failure of 100 AVFs in 70 patients was evaluated during four years. Seventy five cases of CRF patients who were referred for AVF during January 1996 to December 2000 [1375-1379] were selected and operated upon AVF by a given surgeon with the same technique [end-to-side] and followed for two years regularly, In addition to underlying disease such as diabetes mellitus, atherosclerosis and inappropriate vessels another factors such as hypotension and bleeding of aneurismal vessels were recorded when AVF failed. Five out of 75 patients were excluded from this study because of impossible insertion of AVF due to severe damage and thrombosis of peripheral vessels, One hundred AVFs were inserted in 70 patients, 53 in snuff box of left hand, 26 in distal of left forearm, 17 cases in left arm and 4 ones in snuff box of right hand. Thirty percent failed primarily [before dialysis] commonly due to drop in blood pressure and among the remaining 70%, 47 patients had functional AVF for at least 20 months and 23 of them 7.5 months functioned for then failed monthly due to hypotension during hemodialysis [p=0.006]. Hypotension was the cardinal cause of failure of AVFs in CRF patients. We can reduce failure rate of AVFs by monitoring and controlling the blood pressure during hemodialysis and prevent hypotension by salted regimen intake