Sleeve gastrectomy

The aim of our work is to present Experience of Sleeve Gastrectomy at Centre of Bariatric Surgery of Dow University of Health Sciences. All patients were assessed multidisciplinary team before operation. Indications for LSG were BMI 35kg/m[2] with comorbidites and BMI >40kg/m[2] without comorbidities. Standard surgical technique adapted. Gastric division by a cutting stapler. The whole staple line was observed for bleeding and tested for leak. Total 10 patients were studied of which were four males and six females, Median age of was 40 years. Pre-operative median BMI was 52.2kg/m[2] [range from 46 to 61kg/ m[2]]. Median post-operative BMI of 9 months was 34.33kg/m[2] [range from 28 to 40]. Out of 10 patients, observed complications of bleeding was seen in one case and wound infection occurred in 2 cases. Considerable weight loss observed in LSG

Fast ultrasound; a basic tool to evaluate the blunt abdominal trauma patient and help to decision making for emergency surgery

Fast ultrasound is a basic tool to evaluate the blunt abdominal trauma patient and help to decision making for emergency surgery. Observational study. The King Fahad Hospital Madina Munawara, over a period between 2010 and 2011. This study consisted of 765 patients came in Emergency department The King Fahad Hospital Madina Munawara Level II, or Regional Resource Trauma Center Saudi Arabia. Detailed History was taken from all the patients with special regard to bland abdominal trauma. All patients were brought to a trauma resuscitation area where a trauma team conducted a primary survey, after an airway and adequate oxygenation/ventilation were established. The FAST examinations were performed using 4 windows: subxiphoid, right upper quadrant, left upper quadrant, and suprapubic. The critical areas for intra-abdominal bleeding were the hepatorenal space [Morrison's pouch], the spleno-renal space, and the pelvic pouch of Douglas. The FAST examinations were interpreted on the spot and results Recorded. Results were prepared with help of tables and graphs. Data was analyzed through SPSS software. 73 out of 765 patients who underwent FAST ultrasound in the Emergency Room. 40 [54.79%] cases were road traffic accident [RTA] injuries followed by injury due to fall were in 33[45.20%] cases. Findings are fast ultrasound observed 49 out of 73 patients [67.12%] were considered positive FAST who had fluid [blood] in the peritoneal cavity and these patients shift to Operative Room for surgery. While 24[32.87%] patients with no evidence of intraperitoneal fluid were considered negative for FAST and these patient underwent CT scans for evidence of solid organ injury[Chart No.2]. 5 out of 24 cases of solid visceral trauma found on CT scan abdomen, but had not been detected by FAST then shift to operative room after resuscitation. We conclude that FAST ultrasound is very helpful to assessment of blunt abdominal trauma and to detect intraabdominal fluid. Fast ultrasound can help in the quick decision for surgical intervention within minutes of a patient's arrival at emergency department

Compare the complications of laparoscopic versus open appendectomy

To compare the complications of laparoscopic versus open appendectomy. Retrospective study. This study was conducted at Dow University Hospital from June 2012 to June 2014. Data was analyzed by reviewing patient records, patients bills records and patient discharge sheet. Each data was double checked and thoroughly supervised by author himself to assure quality and validation of the data collected. The information reviewed of patients with diagnosis of acute appendicitis included, age, sex, time taken for bowel function restoration, use of analgesia, postoperative stay and its clinical evaluation and confirmed by USG of abdomen requiring operation and total charges. Patients included who were operated in surgical unit I. Patients who were identified with associated gynecological disease, to be at high risk for general anaesthesia, had a past history of lower abdominal surgeries, appendicular abscess were excluded. Data was analyzed through SPSS software. 73 patients who underwent appendicectomy. Out of which 24 [32.87%] patients operated laparoscopically and 49 [67.12%] patients by open method. The mean age for open appendectomy was 26.53 +/- 12.3 years whereas, for laparoscopic appendectomy it was 29.9 +/- 13.3 years. Intraoperative findings were normal appendix 4[16.66%] in OA group and 2[4.08%] in LA group, Acute appendicitis 12[50%] in OA group and 31[63.26%] in LA group, Gangrenous appendicitis 3[12.5%] in OA group and [14.28%] in LA group, Appendiceal abscess 4[16.66%] in OA group and 5[10.20%] in LA group, Peritonitis 1[4.16%] in OA group and 3[6.12%] in LA group. Post operative complications were observed in both groups. Wound infection 5[20.83%] in OA group and 2[4.08%] in LA group, Intra-abdominal abscess 1[4.16%] in OA group and 1[2.04%] in LA group, Bowel obstruction 3[12.5%] in OA group and 2[4.08%] in LA group, Respiratory infection 2[8.33%] in OA group and 1[2.04%] in LA group. This retrospective comparative assessment indicates that the patient chart reduces the incidence of complications in LA was wound infection, intestinal damage, intra-abdominal abscesses, intestinal obstruction and respiratory infections

Bile duct injuries; frequency during cholecystectomy procedures either open or laparoscopic

To find out frequency of bile duct injuries during cholecystectomy procedures either open or laparoscopic.Prospective observational study. This study was conducted at Surgical department, Liaquat University Hospital Jamshoro and Dow International Hospital Karachi, from July 2012 to December 2013. This study consisted of hundred patients. Patients were divided in two groups. Group A for open cholecystectomy [OC] comprising of 50 patients who underwent elective open cholecystectomy. Group B for Laparoscopic cholecystectomy [LC] comprising of 50 patients who underwent elective Laparoscopic cholecystectomy. Inclusion criteria were all patients diagnosed case of gallstones on the basis of ultrasound abdomen, any age and both gender. Exclusion criteria included not willing for surgery, General anesthesia problem, pregnant ladies due to risk of foetal loss, carcinoma of gall bladder, stone in CBD and obstructive jaundice. Out of 100 cases of gallstone were operated for either laparoscopic / open cholecystectmy. In open cholecystectomy group 20[40%] were male and 30[60%] female. Ratio male: female ratio of 1:1.5. In laparoscopic cholecystectomy group 11[22%] were male and 39[78%] female with male: female ratio of 1:3.5. There was wide variation of age ranging from a minimum of 10 year to 70 year in both group. The mean age was 41.28+12.30 years for OC group and 38.44+13.50 years for LC group [p 0.02]. Common bile duct injury were occurred 2[4%] patients in laparoscopic cholecystectomy group while 3[6%] patients observed in open cholecystectomy group. We conclude that found bile duct injury 2[4%] patients in laparoscopic cholecystectomy group while 3[6%] patients observed in open cholecystectomy group