Extrahepatic biliary obstruction; postoperative morbidity and mortality

The objectives of this study are to evaluate the surgical management, both definitive and palliative, in selected patients with biliary obstruction and to find out the postoperative morbidity and mortality in these patients. A descriptive study. Duration of the study is two years conducted from June 2002 to May 2004. The study was carried out at the surgical unit 4 of the Combined Military Hospital and surgical department of the Military Hospital. Thirty eight cases of biliary obstruction were included. A convenient sampling technique was followed. Data analyzed by using SPSS version 10.0 for windows on computer. Descriptive statistics like frequency, percentage, average etc were computed for data presentation. Any inferential test was not found to be applicable for this descriptive type case series. We selected 38 patients with features of extrahepatic biliary obstruction. Out of these [n38] 15 patients [39.5%] suffered from benign diseases while those having malignant diseases were 23 [60.5%]. 19 [50%] patients died within two years of follow up while 19 [50%] were the survivors. Mortality was maximum for the malignant cases. In benign cases only one patient died. Maximum deaths 6 [31.6%] occurred in the period of up to one month of operation. 20 patients had one or another complication of operation and hence the morbidity came out to be 52%. According to our results the mortality and morbidity related to extrahepatic biliary obstruction in our patients was higher compared to other studies which can only be reduced by early detection and treatment

Day case management of varicocele

To evaluate the outcome of treatment of varicocele by low ligation under local anaesthesia and to establish the low ligation as a mode of treatment for early mobilization of the patient and early return to work. Descriptive study. Department of Surgery Combined Military Hospital Rawalpindi from June 2002 to Dec 2002. This study included 50 patients with varicocele irrespective of their age treated by low ligation under local anaesthesia in day case settings and were followed for 3 months. The results of the procedure on the symptoms were quite satisfactory. Post operatively complications were seen in only 8 [16%] patients. Post operative hematoma formation occurred in only 1 [2%] patient, wound infection in 2 [4%] patients, transient pain at the site of operation was present in 2 [4%] patients, transient hydrocele developed in 1 [2%] patient, permanent hydrocele developed in 1 [2%] patient, in 1 [2%] of the patient the dilated veins persisted after the operation even at 3 month follow up. This study concludes that low ligation of varicocele as day case surgery is a very useful day case procedure in the treatment of varicocele that can be very safely carried out under local anaesthesia with a very high healing rate and minimal complications