Incidence of gall stones in Carcinoma gall bladder patients

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

Is routine histopathological examination of the gall bladder a futile exercise?

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

Loop ileostomy as a preferred method of dealing with terminal ileal perforation

Typhoid perforation is common in developing countries especially in women and those under 40 years of age. The size of the perforation may vary from microperforation to 5mm and the most common period is the second week of illness. 22 patients with terminal ileal perforation were treated by two different procedures [closure only and closure with Proximal loop ileostomy]. The results of proximal loop ileostomy were better as there were no deaths compared to two deaths in the closure procedure. The morbidity was also low in the same group as there was no case of faecal fistula or Brust Abdomen