Biomedical subjects

K I Gharaibeh

Publications and source records attributed to K I Gharaibeh.

7 recordsLinked to original sources

PubMed2001

Feasibility of laparoscopic cholecystectomy in situs inversus.

PURPOSE: To address the feasibility and safety of laparoscopic cholecystectomy in situs inversus and highlight the necessary modifications in the surgical technique. PATIENTS AND METHODS: We present our experience in two patients with situs inversus and symptomatic gallstones who were treated successfully by laparoscopic cholecystectomy. The surgeon stood on the right side with the video monitor above the patient's left shoulder. Two 10-mm ports were placed in the epigastric and subumbilical positions. Two 5-mm ports were placed in the left mid-clavicular and left anterior axillary lines. The two procedures were carried out uneventfully after reorientation of the visual-motor skills of the surgeon and cameraman to the left upper quadrant. A summary of a further similar 13 cases so far treated in the English-language medical literature is also presented. RESULTS: Skeletonizing the structures in Calot's triangle consumed extra time and was more difficult than in patients with a normally sited gallbladder. However, the hospital stay and postoperative complications were similar. CONCLUSION: Laparoscopic cholecystectomy in situs inversus seems to be feasible and safe provided it is performed by an expert laparoscopic surgeon who takes time in clearly demonstrating the extrahepatic mirror image anatomy of the biliary tree with its right-to-left shift.

Adult↗

PubMed2001

Laparoscopic excision of splenic hydatid cyst.

Hydatid disease of the spleen is a rare condition. The standard treatment is open total or partial splenectomy. Recently hand assisted laparoscopic total splenectomy for splenic hydatid cyst has been reported. A case is described of splenic hydatid cyst in a 45 year old man that was excised laparoscopically; the related literature is reviewed.

Albendazole↗

PubMed2000

Bupivacaine instillation into gallbladder bed after laparoscopic cholecystectomy: does it decrease shoulder pain?

BACKGROUND: Shoulder pain is common after laparoscopic cholecystectomy (60.5%) and can delay return to normal activities. The cause is unclear but may involve referral of pain from the traumatized area. PATIENTS AND METHODS: A total of 75 patients with chronic cholecystitis who underwent laparoscopic cholecystectomy were randomized into two groups. Group I (37 patients) had 10 mL of 0.25 % bupivacaine instilled into the gallbladder bed and Calot's triangle area at the end of cholecystectomy. Group II (38 patients) served as controls and had no bupivacaine instillation. Postoperative shoulder pain was evaluated. RESULTS: Six patients in Group I developed shoulder pain (16%) compared with 23 patients in Group II (60.5%). The difference was statistically significant (P = 0.0002). CONCLUSION: The raw area of the removed organ is at least partially responsible for shoulder pain after laparoscopic cholecystectomy. Local bupivacaine is effective in reducing such pain.

Adult↗

PubMed2000

To ligate or not to ligate the hernial sac in adults?

OBJECTIVE: Prospective evaluation of the long term effect of leaving the hernial sac open without ligation on the recurrence rate of indirect inguinal hernia repair. METHODS: During the period from July 1987 to July 1990, a total of 60 consecutive patients with 64 indirect inguinal hernia were entered into this prospective study. The indirect inguinal hernia was repaired using Maloney technique with excision of the hernial sac proximally as deep as possible without any attempt to ligate or transfix the sac. All patients were followed up at regular intervals. RESULTS: During the 3-year period, a total of 64 indirect inguinal hernia in 60 consecutive patients were repaired. Their ages ranged between 15-85 years (mean of 50 years). The follow up ranged from 9-12 years (a mean of 10 years and 5 months). Four patients died of unrelated causes. There was no clinically documented case of recurrence in the remaining 56 patients. CONCLUSION: This study, although not controlled, confirmed that non-ligation of the proximal sac during indirect hernia repair was not associated with an increase rate of recurrence.

Adolescent↗

PubMed1992

Bioequivalency studies on tablet formulation of tetroxoprim and sulphadiazine.

The paper describes a comparative bioavailability study on two tablet formulations containing 100 mg of tetroxoprim and 250 mg of sulphadiazine. The comparison was based on the estimated pharmacokinetic parameters from time--serum concentration profiles obtained following the administration of the tablets to 12 healthy volunteers. Statistical analysis performed on the parameters showed that the differences are statistically insignificant and the formulations are bioequivalent.

Adult↗

PubMedDate not supplied

Biliary leakage following T-tube removal.

This study evaluates the incidence of biliary leakage following T-tube removal from the common bile duct (CBD) in 97 patients who underwent open CBD exploration. In 93 patients, this was following exploration for CBD stones, in two patient it was for obstructive jaundice due to hydatid disease and in a further two patients it was following CBD injury. T-tube cholangiography (TTC) was carried out 7-10 days postoperatively and, if the examination was normal, the T-tube was removed 12-14 days postoperatively (2 months for the CBD injury patients). Following T-tube removal, six patients developed severe abdominal pain, sweating and tachycardia. They were treated with antibiotics, parenteral fluids, and analgesia. Three patients settled with this management. Two patients developed sub-hepatic collections and required open drainage. One patient developed a small pelvic collection, which was aspirated transvaginally. A seventh patient was re-admitted 2 weeks following T-tube removal and laparotomy revealed biliary peritonitis. The patient died the following day. Biliary leakage following removal of a T-tube is not uncommon. It has a significant morbidity and mortality. Our experience and that of the reviewed literature suggests that the aetiology is multifactorial. The management and outcome of this complication is discussed.

Adult↗

PubMedDate not supplied

True caecal diverticulitis.

Nine patients (six females and three males), median age = 27.5 years (range 13-36) with caecal diverticulitis are presented. All underwent surgery with a suspected diagnosis of acute appendicitis. Per-operative diagnosis was possible in five cases, two cases were thought to have other benign pathology, but malignancy could not be excluded in the remaining two cases. Local excision was carried out in five cases, a right hemicolectomy was performed in the rest. Histology showed true diverticuli in eight cases, severity of the inflammation made it difficult to comment on the ninth case. Postoperative barium enema was carried out in six cases, which showed no further diverticuli in the colon. We conclude that preoperative diagnosis of caecal diverticulitis is difficult, and that true solitary caecal diverticuli present in a younger age group than the false caecal and ascending colon diverticuli and that they are probably congenital in origin.

Acute Disease↗