RESUMO
To determine the incidence of Gall stones in cases of Carcinoma Gall bladder.Retrospective descriptive study conducted from June 1999 to August 2002.Surgical B Ward of Khyber Teaching Hospital, Peshawar.All patients who were diagnosed as having Carcinoma Gall BladderThe presence or absence of stones was noted in cases of Carcinoma Gall Bladder, detected on preoperative ultrasonography or per-operatively on macroscopic examination, and later confirmed on histopathology. Out of the 40 patients with Carcinoma Gall Bladder in this series, 37 [924%] had Gall stones. There were 34 [85%] females and 6 [15%] males with an age range from 27 to 65 years. Six [15%] patients were in Stage /, 15 [37.5%] in Stage II, 14 [35%] in Stage III, while 5 [12.5%] cases were in Stage IV In 36 patients simple cholecys-tectomy was performed, whereas in 4 patients only biopsy was taken from liver metastasis.There is a strong association of Carcinoma Gall bladder- with gall stones
RESUMO
This study was conducted in Surgical "B" Unit of Khyber Teaching Hospital, Peshawar from October 1998 to November 2003 to look for the incidence of malignancy in apparently benign looking gall bladders. A total of 750 patients, 126 [16.80%] males and 624 [83.20%] females, were included in the study. Cholecystectomy was performed in all these patients for non-malignant diseases, mostly gall stones, and all the specimens sent for histopathology. The biopsy reports of these specimen showed chronic cholecystitis in 512 [68.27%] patients, acute cholecystitis / empyema in 225 [30%] and normal gall bladder in 10 [13.33%] patients; in the latter it was removed as part of other procedures. Three [0.40%] gall bladders, which did not reveal any evidence of malignancy on gross peroperative examination, had primary carcinoma at an early stage i.e. confined to mucosa only. It is, therefore, concluded that early stage carcinoma [Stage I] does occur in normal / non-neoplastic looking gall bladders at operation, but in a negligible number. However, it does not alter the management of these patients, as cholecystectomy is the only treatment for early carcinoma. Hence selective histopathology of gall bladder is safe and recommended, as it will save the un-necessary expenditure on routine biposy of every case
RESUMO
To compare the techniques of end-to-side and side-to-side anastomosis in arteriovenous fistulae construction in terms of success rate and immediate postoperative complications. Design: Comparative study. Place and Duration of Study: Ayub Hospital Complex, Abbottabad, from October 1999 to December 2002 and Khyber Teaching Hospital, Peshawar, from January 2003 to December 2003. Patients and One hundred and ninety patients with end stage renal disease [ESRD] were included in the study. Arteriovenous fistula was constructed in these patients by two techniques i.e. end-to-side and side-to-side anastomosis. The two methods were compared in terms of duration of surgery, immediate success rate and short-term complications. Among 190 patients, 118 [62%] were males and 72 [38%] females. The age ranged between 24 to 66 years with average age of 54 years. Side-to-side anastomosis was done in 120 [63%] patients while end-to-side in 70 [37%] patients. The average duration of surgery in side-to-side group was 50 minutes and in end-to-side group it was 75 minutes. Bleeding occurred in 4[5.7%] cases in end-to-side group and 2[1.7%] patients in side-to-side group requiring reexploration. The immediate failure rate of the procedure was 2.5% in side-to-side group and 7.5% in end-to-side group. Wound infection occurred in 1[1.4%] case in end-to-side group and 2[1.7%] cases in side-to-side group. In patients with end stage renal disease [ESRD] arteriovenous fistula construction by side-to-side anastomosis is less time-consuming and has less complications as compared to end-to-side technique