Partial cystectomy and omentoplasty for liver hydatid cyst

Objective: To evaluate the results of partial cystectomy and omentoplasty in the management of hepatic hydatid disease

Study design: Descriptive case series

Place and Duration of study: Department of Surgery, Hayatabad Medical Complex Peshawar, from March 2011 to February 2015

Methodology: The study included patients diagnosed to have hydatid cyst involving right lobe of liver using ultrasound and CT scan abdomen. Patients having hydatid cyst in the left lobe of liver or other viscera were excluded. Postoperatively complications like bile leak were noted

Results: Partial cystectomy and omentoplasty for hepatic hydatid disease produced satisfactory results with minimum complications and short hospital stay

Conclusion: A total of 26 patients with liver hydatid cyst underwent partial cystectomy and omentoplasty. Male to Female ratio was 2.7:1. Mean age of the patients was 44.51 year. The operating time was from 45-90 minutes. Postoperatively 02 [7.7%] patients had bile leak, 03 [11.5%] had wound infection and 01 [3.8%] patient developed recurrent hydatid cyst in the liver. The average hospital stay was 5.4 days. There was no postoperative mortality

Postoperative outcome of early laparoscopic and open cholecystectomy for acute calculous cholecystitis

Objective: to assess the optimal timing of intervention and post-operative morbidity for acute calculous

Cholecystitis

Study design: cross sectional study

Place and Duration of study: surgical unit Hayatabad Medical Complex Peshawar, from February 2015 to January 2016

Methodology: a total of 110 patients having age range of 20-55 year were included. Patients having common bile duct stones, clinically jaundiced and associated co morbid diseases, were excluded. Patients were divided into two groups having 55 patients in each group. Group A patients underwent early laparoscopic / open cholecystectomy within 72 hours of presentation while group B patients had delayed laparoscopic / open cholecystectomy after 72 hours of presentation. In both the groups laparoscopic cholecystectomy was attempted initially but in difficult cases decision was made to convert to open procedure. Postoperative morbidity of both groups was compared

Results: mean age of the study population was 40.5+2.5 year. Male to female ratio was 1: 8.2. Biliary leak occurred in 1.8% patients in group A and 5.5% in group B. Common bile duct injuries occurred in 1.8% versus 3.6% patients and conversion rate was 3.6% against 12.7% in group A and group B respectively. Hospital stay in group A patients was 2.5 days as compared to 4.5 days in group B. Overall complication rate was 7.2% and 29.1% for groups A and B

Conclusion: early laparoscopic cholecystectomy within 72 hours significantly decreased the conversion rate, postoperative morbidity and the length of hospital stay

experience with continent urinary diversion

Objective: to find out frequency of urinary continence and surgical complications of using cecum and right colon as reservoir with appendix as a continent catheterizable conduit in various urological conditions in adults

Study design: retrospective study

Place and Duration of study: department of Surgery, Hayatabad Medical Complex and Khyber Teaching Hospital, from January 2005 and December 2015

Methodology: this is a review of records of patients who underwent continent urinary diversion. Reservoir was constructed from cecum and right colon using Le Bag technique. Appendix was used as a catheterizable port applying Mitrofanoff principle. Patients were followed up for six months at two months interval

Results: a total of 85 patients underwent continent diversion and 78 patients completed the study protocol. Four patients were lost to follow up and three died. Out of 78 patients, 48 were males and 30 females, with age range from 05 year to 68 year. Thirty-eight [48.71%] patients presented with transitional cell carcinoma, and 12 [15.38 %] had exstrophyepispadias complex. Reservoir formation using right colon with appendix for Mitrofanoff was performed in 53[67.94%] patients. Eleven [14.10%] patients underwent bladder augmentation procedure with Mitrofanoff and in 14 [17.94%] patients appendix alone was used for diversion. Thirty-two [41.02%] patients developed complications which included incisional hernia [n=7 - 8.97%], calculous formation [n=1 - 1.28%] and subacute intestinal obstruction [n=2 - 2.56%]

Conclusion: use of appendix as a catheterizable conduit is a good option in achieving continent urinary diversion