Laparoscopic cholecystectomy in Iraqi patients

Laparoscopic cholecystectomy was introduced into Baghdad Teaching Hospital, Saddams medical city in April 1994. The aim of this study was to evaluate the results of the procedure in Iraq to obtain some insight into its safety and efficacy in general surgical practice, 65 cases were performed after the diagnosis of patients with gall stones disease by history, clinical examinations and investigations, 53 were females and 12 were males with an average age 44.3 years ranging from 16-70 years. 2 cases [3%] were converted to open cholecystectomy the average operation time was 68 minutes with a range between 30-120 minutes, most of the patients were discharged in the second post operative day, more than 75% of the patients moved out side their beds after eight hours with little post operative pain and one to two doses of analgesia were given for most of them, the range of return of the patients to their usual activity was between 7-18 days with a median of 10 days. Complications included wound infection in 12 patients, subphrenic abscess in one patient, retained stone in the C.B.D. in one case, myocardial infarction in one case. There were no injuries to C.B.D. or bowel during our operations

Fine needle aspiration cytology versus histopathology in diagnosing lymph node lesions

Fine needle aspirates [FNA] of superficial lymph nodes were obtained from 150 patients complaining of lymphadenopathy. Cytological findings were analysed in correlation with the corresponding histopathological diagnosis of the same excised nodes. Benign lesions were found in more than half of the patients [55.3%], the majority of which were nonspecific reactive hyperplasia followed by tuberculous lymphadenitis. Lymphomas constituted the main pathology in malignant involvement [26.0%], while metastatic lesions formed 16.7% and leukaemia 2.0%. The results of FNA compared favourably with those of tissue biopsies, with an accuracy rate of 89.6% for malignant lymphadenopathy. The appropriate use of FNA may obviate the need for an open biopsy

Incisional hernia repair

A new method of repair of large incisional herniae in 42 patients is reported. The method has simplified this procedure by using nylon darn technique. The results are compared with those of other comparable series using different techniques. The recurrence rate in this series is substantially less than that reported with these alternative techniques

Early cholecystectomy in acute cholecystitis

Of 260 patients with acute cholecystitis admitted to the third surgical unit at the Medical City Teaching Hospital, Baghdad, 216 patients were treated by early [up to 72 hours after admission] surgical intervention with no mortality. Complications included 8 patients who had wound infection and one with deep venous thrombosis. Cholecystectomy was preferable to cholecystostomy, the latter was necessary in only 20 patients [9%]. Exploration of the common bile duct was done in 80 patients of the early operated group, in less than half of these patients stones were recovered from the common bile duct