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A W Meshikhes

Publications and source records attributed to A W Meshikhes.

10 recordsLinked to original sources
PubMed2002

Asymptomatic gallstones in the laparoscopic era.

Recent introduction of new treatment options has significantly altered the approach towards gallstone management. There is now general agreement that cholecystectomy is the treatment of choice for symptomatic gallstones. Controversy, however, exists as to the management of asymptomatic gallstones. The ready availability of abdominal ultrasonography for the investigation of a wide range of abdominal symptoms has resulted in the increased diagnosis of asymptomatic gallstones. Management of such accidentally discovered gallstones poses a dilemma as conclusive evidence of the benefits of cholecystectomy is lacking. This is further complicated by the fact that the majority of asymptomatic gallstones remain so and patients rarely experience symptoms or complications. Furthermore, cholecystectomy is associated with a low but recognised morbidity. Recent introduction of laparoscopic cholecystectomy as the treatment of choice of symptomatic gallstones has further complicated the issue of asymptomatic gallstone management. This article reviews the current management of asymptomatic gallstones in the era of laparoscopic cholecystectomy

Anemia, Sickle Cell↗
PubMed2001

A problem bile duct stone.

Explore the source record for details and available documents.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed2000

Duodenal and ampullary obstruction by a Peutz-Jeghers polyp.

We report a case of Peutz-Jeghers syndrome presenting with obstruction of the second part of the duodenum and the ampulla of Vater by a large intra-luminal polyp leading to duodenal obstruction and obstructive jaundice. CT scan of the abdomen showed a large polypoidal lesion, a caecal polyp and jejuno-jejunal intussusception. At surgery, two intussusceptions were reduced and leading polyps were excised via two enterotomies; the caecal polyp was excised via caecotomy. The duodenal polyp was excised by limited duodenectomy after frozen section has shown no evidence of malignancy. Histopathological study of all the excised polyps including that of the duodenum showed hamartomatous polyps with no malignant changes. Apart from acute bleeding, this case highlights many of the surgical gastrointestinal complications of Peutz-Jeghers syndrome. It also highlights the unusual combined duodenal and common bile duct obstruction by a large Peutz-Jeghers polyp. The controversial association of this syndrome with cancer and management options is also discussed.

Adult↗
PubMed2000

Attitude of patients attending the surgical clinic towards a day surgical unit.

OBJECTIVES: To establish awareness and attitude of patients attending the general surgical clinic in Dammam Central Hospital, Dammam, Eastern Province towards a day surgery unit. Also, to establish the reasons for their preference to have surgery performed as inpatients or in the day surgery unit. METHODS: Some 100 consecutive patients attending the surgical clinic of a single consultant surgeon at Dammam Central Hospital were surveyed. Patients who can neither read nor write were excluded. They were asked to answer a simple questionnaire on day surgery and their preference to have their minor operations under general anesthesia performed as a day surgery procedure or as an inpatient. RESULTS: There were 64 males and 36 females of various professions. Ninety-four patients aged 15-45 years. Thirty-two patients gave the correct definition of day surgery while 38 patients did not know, and had never heard of the term and 30 patients gave wrong definitions. Only 30 patients preferred their surgery to be conducted as day surgery. Forty-five of 70 patients (64%) who preferred inpatient care felt they would be receiving better care in hospital and 16 (23%) felt happier to be looked after by their surgeon in the first few postoperative days to avoid complications. Nine females of the 70 patients who preferred inpatient surgery (13%) felt that hospital is a better place for rest after surgery and to get a way from husband, children and housework. CONCLUSION: The majority of our patients are unaware of the safety and services provided by a day surgical unit. Major work is needed to educate patients attending our clinics about the advantages of day surgery with the aim of improving their attitude towards it.

Adolescent↗
PubMed1998

Sickle cell disease and the general surgeon.

Sickle cell disease (SCD) is a common genetic disorder which represents a major medical problem in certain parts of the world. It is characterized by chronic haemolytic anaemia and vaso-occlusive crises, which can lead to widespread vascular occlusion by sickled red blood cells leading to multiple organ infarctions. In this respect, SCD can be considered as a multisystem disease presenting, to various surgical disciplines, a wide variety of surgical ailments. As surgical management of these patients is associated with high morbidity and mortality, close collaboration between medical and surgical services is essential. Greater population mobility makes recognition of the surgical implications of this disease of paramount importance in surgical practice. This article reviews surgical problems with which SCD patients may present to general surgeons and discusses their management.

Anemia, Sickle Cell↗
PubMedDate not supplied

Laparoscopic cholecystectomy: the Dammam Central Hospital experience.

Over a one year period (June 1992-June 1993), 260 patients (208 females and 52 males) with mean age of 37 years (range 13-80), underwent laparoscopic cholecystectomy (LC) for symptomatic gallstones. Thirty patients were admitted as emergency (20 acute cholecystitis, 10 acute pancreatitis). The procedure was performed successfully in 232 cases (89%). In 28 patients (18 electives, 10 emergencies), the procedure was converted to open for a variety of reasons, difficult anatomy being the commonest. Our mean operative time was 99.9 minutes (range 30-290 minutes). There were 3 major complications (2 common bile duct injuries and one abdominal aortic injury) and 4 minor complications (2 wound infections, one prolonged ileus and one chest infection). There was one death due to sickle cell crisis on the fifth post-operative day. The mean hospital stay was 2.3 days and 6.5 days for LC and converted cases, respectively. Our results suggest that laparoscopic cholecystectomy can be offered and conducted safely and effectively in the great majority of patients presenting acutely or electively with cholelithiasis, and that the results we achieved during the first year of our experience with LC is comparable to those reported from Europe and North America.

Adolescent↗