RESUMO
Objective: To have an audit of the outcome of laparoscopic cholecystectomy for acute cholecystitis at a tertiary care centre. Study Design: An observational study. Place and Duration of Study: Department of Surgery, Prime Teaching Hospital, Peshawar Medical College, Peshawar, KPK, Pakistan, from January 2011 to December 2015
Methodology: Patients with acute cholecystitis undergoing laparoscopic cholecystectomy were evaluated for conversion rate, morbidity and hospital stay. Early laparoscopic cholecystectomy was defined as done within the same hospital admission
Results: In 83 patients, male to female ratio was 1:1.6 with a median age of 46 years [IQR 15]. The median interval between the onset of symptoms and time of surgery was 5 days [IQR 3]. Majority of cases [80%] were performed after 72 hours of their presentation as acute cholecystitis. Conversion rate from laparoscopic to open cholecystectomy was 8.4% [7/83 cases], because of difficult dissection and unclear anatomy at the Calot's triangle. Median duration of hospital stay was 2 days [IQR 1]. Morbidity rate was 9.6% [8/83 cases], all occurring in late presentations; port-site infection being the commonest [n=6, 7%], followed by port-site hernia and post-cholecystectomy pancreatitis [n=1 each]
Conclusion: Laparoscopic cholecystectomy is quite safe in acute cholecystitis with a low conversion rate, bile duct injuries, and hospital stay
RESUMO
Nipple adenoma is a benign condition simulating malignancy such as breast carcinoma and/or Paget's disease clinically. In this study 19 cases diagnosed as nipple adenoma over a period of 14 years are described. The diagnosis was confirmed by histology alone. All patients were females with age ranging from 23 to 63 years. Most of the cases presented clinically with in duration and ulceration accompanied by pain and itching. The diagnosis was clinically suspected in only 3 cases. This highlights the importance of histological diagnosis in all suspicious breast lesions. In one case, the clinical and histological diagnosis was incorrect leading to mastectomy. Complete local excision with clear margins is curative