ABSTRACT
Laparoscopic cholecystectomy [LC] is a surgical procedure for symptomatic gallstones. LC was first performed in France in 1987. It is a safe and reliable operation for both acute and chronic cases in almost all age groups. LC was introduced to the hospitals of Mosul, Iraq 1995. This study aims to evaluate prospectively the technology of LC in first 300 selected cases mainly in the fields of conversion rate to open cholecystectomy, steps of the technique and its complications. Over a three-year period, from September 1995 to September 1998, a prospective evaluation of 300 patients selected for LC in Mosul hospitals was carried out. In this study of LC in 300 patients, the conversion rate to an open cholecystectomy [OC] was 5%, mainly due to inability to define Calot's triangle and dense adhesions. The conversion rate was decreased from 10% in first 100 cases to 1% in the third 100 cases due to the improvement of the learning curve. In this study, cystic artery coagulation was successful in most of the cases instead of using liga-clip. One liga-clip for cystic duct occlusion near its common bile duct [CBO] junction was successful in 95% of the third 100 cases. There was no in- hospital mortality, no bile duct or viscus injury in this series. The postoperative complications were minor and minimal in 31 .3% of the cases. We conclude from this study that LC is a safe procedure and has minor complications and that this procedure should be the standard one for symptomatic cholecystolithiasis. We suggest that this procedure get started in other hospitals of Iraq after adequate training and experience
ABSTRACT
A clinicopathoIogical study of young patients with colorectal carcinoma, aged 40 Years and under, were studied during the period [1984 - 1990]. There were 83 patients Out of 200 with colorectal cancer in this age group [41.5%]. This percentage was found to be higher than those reported by other workers. The explanation for that and the Dukes staging of such patients was considered and discussed. The most common presenting symptoms were abdominal pain, rectal bleeding and changes in bowel habits. The histological pattern was mostly of moderately [38.6%] and poorly differentiated [39.7%] types with mucinous changes. It was concluded that such tumours in this age group is much higher in this country [North of Iraq] than those- reported in other countries and the incidence of the mucinous variety is higher too. This finding is reflected in the Dukes staging of such patients where roost of them were staged B and. C. Proper follow up and satisfactory recording is essential to assess prognosis