Perforated duodenal ulcer managed by simple closure versus closure combined with truncal vagotomy and drainage or proximal gastric vagotomy with closure

The present study included 40 patients with perforated duodenal ulcer. They were 30 male and 10 females. 15 patients subjected to simple closure. Only 10 patients had closure combined with proximal vagotomy. In the present study, no intraoperative complications or morbidity occurred in the three groups. The recurrence rate after simple closure was 80% against 10% in closure combined with truncal vagotomy and drainage. 2 patients [13.3%] developed recurrent ulcer after closure combined with proximal vagotomy

Early cholecystectomy for acute gall bladder disease

Over a 2 year period [1991-1992] a total of 220 cholecystectomy have been performed in Bab El-Shaeria Hospital, Al-Azhar University. Of these 60 patients were presented with symptoms and signs suggesting a picture of an acute cholecystitis. All the 60 patients were subjected to early cholecystectomy. There is no technical difficulty in performing early cholecystectomy or operative complications, but there is increasing blood loss relatively in comparison to elective cholecystectomy. The time of operative procedure was more or less equal in both groups. All patients of complicated gall bladder concerned to patients over 70 years of age. Also, the period of hospital stay was equal in both groups. 4 non fatal postoperative complications [6.66%] occurred after early cholecystectomy. Also, 9 non fatal postoperative complications [5.7%] occurred after elective cholecystectomy

Milligan Morgan's Haemorrhoidectomy with or without sphincterotomy

The present study included 100 patients with primary hemorrhoid not associated with any other lesions. 40 patients had a hemorrhoidectomy as described by Milligan Morgan and 60 patients had Milligan Morgan's hemorrhoidectomy combined with lateral internal sphincterotomy. 30 out of 40 patients developed postoperative pain [75%], also, 4 out of 40 patients had postoperative anal stenosis [10%]. No bleeding or incontinence occurred in this group and complete healing occurred within 6 weeks. 2 out of 60 patients [3.3%] developed post-operative pain. No anal stenosis or incontinence occurred in this group. Also, there is no postoperative bleeding and complete healing occurred within 6 weeks. The present study denoting that the Milligan Morgan's hemorrhoidectomy is usually associated wit postoperative pain while if it is associated with lateral internal sphincterotomy the postoperative pain is mild and does not need the use of analgesia

Role of surgery in asymptomatic gall stones

The present study included 30 patients with asymptomatic gall stones detected accidentally on ultrasonography for another abdominal complaint unrelated to gall stone symptoms. All of them had oral cholecystography and cholecystectomy. The gall bladder specimens subjected to histopathology. The cholecystography showed non functioning gall bladder in 80% of cases and the pathological findings showed a picture of chronic cholecystitis in 90% of cases

Complete central duct excision for nipple discharge

The present study included 50 female patients represented with nipple discharge. The patients under age of forty years and patients with breast lump were excluded from this study. All of them subjected to complete clinical evaluation and investigation. Also all the patients had complete central duct excision to assess the value of this operation in treatment of nipple discharge in this age group, the present study denoting that, this procedure is a satisfactory operation in treatment of nipple discharge, it identified the cause of nipple discharge and abolished the nipple discharge