audit of cholecystectomy

To evaluate the results of Cholecystectomy in our practice. Prospective, descriptive study from January 2006 to December 2006. Hamdard University Hospital and private hospitals. A total of 150 patients who underwent cholecystectomy were included in this study. The dats of all the patients who underwent cholecystectomy was entered on a proforma and analyzed. Out of the total 150 patients, 75% were females and 25% males, with an age range of 20 to 76 years. The duration of symptoms was from one day to three years. Laparoscopic Cholecystectomy was attempted in 118 [78.66%] patients and completed in 104 [88.13%] patients; 13 [11.11%] patients required conversion, while in one case the procedure was abandoned due to abdominal tuberculosis. The remaining 32 patients underwent planned open cholecystectomy for various reasons. The comparison of our work with national and international studies showed that Laparoscopic Cholecystectomy in our set up is up to the accepted standard. More emphasis is needed to properly train young surgeons in the field of Laparoscopic surgery

Is laparoscopic cholecystectomy treatmen1 of choice in acute cholecystitis?

To evaluate the role of early laparoscopic surgical intervention in acute cholecystitis in our setting. Descriptive study. At Hamdard University Hospital and some other private hospitals of Karachi from July 1998 till July 2005. All cases of acute cholecystitis admitted under our care at Hamdard University Hospital and some other private Hospitals of Karachi were included in this study. The data collected through review of files for presenting symptoms and signs, biochemical findings and histopathology of resected gall bladder specimen. Those cases who had known history of cholelithiasis and had a recurrent attacks we also included in this study. Those patients who had clinical jaundice, ultrasound examination suggestive of dilated common bile duct [CBD], impacted stone in CBD, empyema gall bladder on ultrasound with swinging pyrexia were excluded from the study. There were 516 cases of acute cholecystitis with the age range of 16 to 80 years. All cases were operated within 24 to 48 hours after admission. Our conversion rate was 6.4% with the mean operating time of 55 minutes. Laparoscopic cholecystectomy is a safe and effective procedure in acute cholecystitis in experienced hands

Feasibility and effectiveness of ESWL for selected vesical calculi

To assess the feasibility and effectiveness of ESWL for selected Urinary Bladder stones. Retrospective quasi experimental study from September 2004 to February 2007. The Stone Center, Taj Medical Complex, Karachi. Twenty six consecutive patients of over 12 years of age with bladder stones of less then 2.5 cm and without symptoms of outflow obstruction. Detailed clinical work-up of all the patients was done. The diagnosis of bladder stone was made either on an IVP or an ultrasound combined with X-ray KUB. Bladder outflow obstruction was excluded on clinical grounds. All patients received shock waves ranging from 14 to 20 kV, up to a maximum of 3000 shocks in a single session. If complete fragmentation was seen before this, the treatment was stopped. Patients were reviewed after 72 hours with a KUB X-ray. Patients with residual stones received a 2nd session at this stage. If no fragmentation was seen after two sessions, the patients were offered alternate modes of treatment. If there was any residual fragment left after two sessions, a third session took place. During the study period, 31 patients presented with bladder stones. Two patients with significant outflow obstructive symptoms, one patient with a stone of 3.5 centimeters and two children [age<12 years] were excluded from the study. Of the 26 remaining patients, 19 were males and seven females. Eighteen patients had complete stone clearance after one session and five after two sessions, while one patient required three sessions for complete stone clearance. Two patients did not have any significant fragmentation and were offered alternate treatment modalities. Overall 24 out of 26 [92.3%] patients had a complete stone clearance. ESWL is a very effective and safe modality for treatment of selected bladder stones. The treatment can be provided on an out-patient basis

Peyronie's disease

Peyronie's disease is an uncommon condition and authors have not seen it in their practice. This is our first experience which is reported here