Assessment of choledochoduodenostomy as a method of permanent drainage

This study included 12 patients presented with clinical findings suggestive of calcular obstructive jaundice. All patients were examined clinically and fully investigated with special attention to liver function tests. Cholecystectomy and side to side choledochoduodenostomy were done for every patient as a method of permanent biliary drainage. Minor biliary leakage occurred in one patient [8.4%] which healed spontaneously. Wound infection developed in two patients [16.7%], and chest infection in one patient [8.4%], all were treated medically. Only one patient developed cholangitis 9 months postoperatively and responded well to medical treatment. No operative mortality or stump syndrome in this group of patients. The long term follow up study of this group of patients showed good results in more than 90%, fair result in one patient with cholangitis and there was no poor results in this group. Both postoperative safety of this procedure

use of gentamicin beads in the treatment of pilonidal sinus

This study included 47 patients with pilonidal sinus, divided into two groups. The first group included 32 patients treated by surgical excision and primary closure of the wound on "gentamicin beads" which were withdrawn, one bead every day, starting from the second post operative day. The second [control] group formed of 15 patients, was treated by complete surgical excision, primary closure of the wound on a continuos negative suction drainage, intra and post-operative systemic gentamicin antibiotics for days. Sound healing was achieved in about 97% of our patients of the first group in 10 to 15 days, while only about 3% of the patients developed recurrence. In the control group our patients passed smooth post operative period with sound healing of their wounds in 2-3 week. Minor would infection occurred in 13.3%, major wound infection 6.7% and recurrence of the sinus in 6.7% of our patients. Our method of treatment adopted for patients of the first group is simple, effective and applicable for all forms of pilonidal sinus, with minimal recurrence rate, reasonable hospital stay period, healing time and minimal discomfort to patients

Assessment of cervical rib excision in the thoracic outlet syndrome

The efficacy of a cervical rib of symptoms in patients with thoracic outlet syndromes has been the subject of debate. This study describes our experience of 20 cervical rib excision in 12 patients: complete recovery was much more common in patients with neurological symptoms than with vascular or mixed symptoms alone 5 were cured, 2 were improved and one was not helped, in contrast of 5 patients with purely vascular symptoms 2 cases were cured and 2 improved and one was not improved. While in 7 patients with mixed symptoms only one patient was cured and 2 improved and the remaining four got no benefit from the operation