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Article
Conversion Rate in Laparoscopic Cholecystectomy: A Review of 300 Cases

Authors: Abbas A. Al-Jubori --- Fadhil A. Al-Janabi --- Raad S. Al-Saffar
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2010 Volume: 3 no.1 Issue: 6 Pages: 772-778
Publisher: Kerbala University جامعة كربلاء

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Abstract


background : Prediction of a difficult laparoscopic cholecystectomy (LC) can help the patient as well as the surgeon to be better prepared for the intra-operative risk and the risk of conversion to open cholecystectomy. The difficult gallbladder is the most common 'difficult' laparoscopic surgery being performed by general surgeons all over the world and the potential one that places the patient at significant risk. We present our experience of 300 cases since September 2007 to December 2009 in a single center with respect to conversion to open cholecystectomy.
AIM: evaluation of difficult laparoscopic cholecystectomy and conversion rate in different 300 cases of cholelithiasis.
Methods: Patients who underwent laparoscopic cholecystectomy (LC) from September 2007 to December 2009 were analyzed. The cases were analyzed in relation to conversion rate to open surgery; factors affecting pulmonary disease were not included in the study.
Results: Out of 300 cases, 52 patients (17.33%) were identified as difficult cases. Laparoscopic cholecystectomy was successfully completed in 295 patients with a completion rate of 98.33%. Laparoscopic procedure had to be converted to the open procedure in 5 patients with a conversion rate of 1.66% of the total LCs performed and 9.6% of the difficult cases. Conversion had been done due to several reasons.
Conclusion: It can be reliably concluded that LC is the preferred method even in the difficult cases. Our study emphasizes that although the rate of conversion to open surgery and complication rate are low in experienced hands the surgeon should keep a low threshold for conversion to open surgery and it should be taken as a step in the interest of the patient rather than be looked upon as an insult to the surgeon.
Key words: conversion, laparoscopy, cholecystectomy.


Article
4- CAUSES AND INCIDENCE OF LAPAROSCOPIC CHOLECYSTECTOMY CONVERSION

Authors: Adnan Y Abdulwahab --- Safwan A Taha --- Salam T Mutlak
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 1 Pages: 20-24
Publisher: Basrah University جامعة البصرة

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Abstract

Four hundred cases of laparoscopic cholecystectomy candidates wereprospectively followed at the time of surgery by obtaining a data sheet for thepatient’s age, sex, time from the introduction of ports till decision of conversionand the cause of conversion if present in two years (2006 & 2007) period.From 400 laparoscopic cholecystectomy, 20 conversions were obtained and thecauses were; wide cystic duct, empyema of the gall bladder, severe obesity, livertumor, abnormal position of gall bladder, vascular variation and dense adhesionswith disturbed anatomy. The percentage of conversion was 5%. Eight conversioncases were males from the total 45 male patients underwent laparoscopiccholecystectomy. Twelve cases were females out of 355 female patientsunderwent laparoscopic cholecystectomy. The percentage of conversion for malepatients was 17.7% while in female patients was 3.3%. Our results showed thatthe conversion rate in this study was 5% and the most common cause forconversion is dense adhesions. No biliary duct injury or severe bleeding thatneed conversion is found in this study and the rate for conversion is higher inmale patients.


Article
Seismic and Velocity Study of Luhais Oil Field Using Velocity Model
دراسة زلزالية وسرعية لحقل اللحيس النفطي باستخدام موديل السرع

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Abstract

In this study, a qualitative seismic velocity interpretation is made up through using 2D-seismic reflection data on Luhais oil field in southern of Iraq which is situated at about 105 Km to the east from the Basra city. Luhais oil field was chosen to study the type and nature of the distribution of the seismic velocities of Nahr Umr and Zubair Formations in order to show its explorational importance, where these formations contain abundant quantities of hydrocarbons. Picking of the tops of Nahr Umr and Zubair was carried out from the synthetic seismogram which is calculated from sonic-logs and check shot of well Lu-2. Velocity model was obtained via using an implementation of Petrel program version, 2013 and was corrected according to tops well that drilled in the study area. Average velocity slices (vertically and horizontally) and maps are carried out from the velocity model

تم أجراء دراسة تفصيلية نوعية سرعية في التفاسير الزلزالية وذلك من خلال أستخدام بيانات الانعكاس الزلزالي الثنائي الأبعاد لحقل اللحيس النفطي في جنوب العراق والذي يبعد شرقا عن مدينة البصرة حوالي 105 كم. لقد تم أختيار حقل اللحيس النفطي لأجراء دراسة عن نوع وطبيعة توزيع السرع الزلزالية لتكويني نهر عمر والزبير وذلك لأهمية المنطقة من الناحية الاستكشافية. أذ يحتوي على كميات وفيرة من الهيدروكابونات خصوصا في تكويني نهر عمر والزبير. في بداية البحث تم عمل الأثر الزلزلي المصنع للبئر المحفور ضمن منطقة الدراسة (لحيس-2) بأستخدام المجس الصوتي والسرع الزلزالية للبئر المذكور. وعلى ضوء ذلك تم تعريف والتقاط العواكس الزلزالية المطلوب دراستها في هذا البحث وهي (أعلى عاكس نهر عمر, أعلى عاكس الزبير). كذلك تم بناء موديل سرع ضمن تطبيقات برنامج Petrel)) والمصحح نسبة الى أعماق التكوينات المستحصلة من الابار المحفورة ضمن منطقة الدراسة ومنه تم عمل شرائح سرعية معدلية (عمودية وافقية) وخرائط سرع معدلية.


Article
Early Laparoscopic Versus OpenCholecystectomy for Acute Cholecystitis

Author: Mumtaz K. H. AL-Nasir
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 76-81
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Acute cholecystitis is common surgical problem, which was treated previously by conservative treatment .Later early open has been introduced as an alternative to interval for treatment of acute cholecystitis. Early open was found to be a safe, successful with comparable postoperative complication rate. With the advent of laparoscopy laparoscopic have been used for chronic cholecystitis and became the first line of treatment. New reports have shown that laparoscopic can be used as an alternative to open for surgical treatment of acute cholecystitis.
Objectives: to compare the success, safety of early laparoscopic versus early open as a primary treatment of acute cholecystitis.
Methods: out of 68 patients were treated for clinical acute cholecystitis between January 2002 and February 2004 in the department of surgery, at Al – Kindy teaching hospital. A total of 62 patients underwent early for acute cholecystitis as soon as possible after diagnosis. The preferred preoperative imaging technique was ultrasound. 30 (48.3%) of the operations were attempted laparoscopically, whereas the remaining 32 patients (51.7%) underwent initial open .
Results: The mean operative time for the open cases was 75 minutes versus 60 minutes for the laparoscopic group. There was no perioperative mortality in either group. The incidence of conversion to open was 10% (3 patients). Surgical complications related to laparoscopic and open occurred in 2 (6.6%) and 3 (9.3%) cases, respectively. There was no difference between the open and laparoscopic groups in regard to the major postoperative complications.
Conclusion: The current study shows that early (whether performed by open or laparoscopically) is a safe and effective treatment for acute cholecystitis. Low conversion rates can be maintained with strict guidelines for appropriate patient selection, adequate experience, and proper laparoscopic technique.
Key Words: Acute cholecystitis– Conversion rate – Laparoscopic .


Article
A study of clinical characteristics and psychosocial stressors in patients with conversion disorder

Authors: Waleed Azeez Al-Ameedy1 --- Maythem Al-Yasiry --- Zeid Al-Yasiry
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2016 Volume: 9 Issue: 1 Pages: 2357-2364
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Conversion disorder is the term used in the Diagnostic and Statistical Manual of Mental disorders-Fourth edition classification system (DSM-IV). It was coined by Sigmund Freud.Objectives: To study and stratify the clinical presentation and psychosocial stressors of patients with conversion disorder. Method: The sample is composed of 182 patients (52 males and 130 females) referred from emergency department to psychiatry outpatient clinic. DSM-IV criteria were used to diagnose conversion disorder. The Social Readjustment Rating Scale by Holmes and Rahe which ranks the effects of life events was used in our study. Results: (70.3%) of the patients presented with psychogenic non epileptic seizures. Of the referred cases, 76.9% have had previous history of the same condition and 31.9% had previous referral to psychiatrist. There was significant association between score interpretation of the Social Readjustment Rating Scale by Holmes and Rahe and age, gender, occupation, marital status and previous admission for the same condition.Conclusion: Episodes of conversion disorders are triggered by psychosocial stressors the severity of which does not seem to correlate with the risk of relapse. The highest incidence of conversion episodes were detected in married, unemployed young females with lower levels of education. The prognosis of those patients improves with early identification and proper psychiatric assessment and management.


Article
Laparoscopic colorectal surgery in Baghdad teaching hospital A review of 12 patients
جراحة القولون والمستقيم المنظارية دراسة حول 12 مريض في مستشفى بغداد التعليمي.

Author: Ahmed S. Ahmed احمد صالح أحمد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2018 Volume: 60 Issue: 1 Pages: 1-4
Publisher: Baghdad University جامعة بغداد

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Background: colonic resections by laparoscopy are being performed with increasing frequency worldwide.Objective: The aim of this study is to evaluate our experience in the laparoscopic management of colorectal disease and to compare our results with other institutes.Patients and Methods: This is a prospective study conducted during the period from 1st of January 2017 till the 15th of November 2017, 12 patients underwent laparoscopic colectomy in in Baghdad Teaching Hospital and followed up for 30 days postoperatively.Results: 12 patients were included in this study, 83.3% of them were male, majority of patients (41.7%) were between 60 – 69 years, most of the patients (33.3%) have a body mass index of 23 -25, 83.3% of operations took 240 – 360 minutes and malignant diseases was the most common indication for surgery with (58.3%), while Abdominoperineal Resection was the most common indication for laparoscopic intervention (25%). Half of the patients discharged from hospital in 96-120 hours postoperatively, furthermore in majority of cases (66.7%) bowel sounds return to normal in 48-72 hours postoperatively. Conversion to open procedure occurred in 16.7% of patients, while complications occurred in 16.7% of patients.Conclusion: Although laparoscopic colorectal surgery is a not popular in our institute, our results are promising.


Article
LAPAROSCOPIC CHOLECYSTECTOMY: ATHREE-YEAR RETROSPECTIVE STUDY
استئصال المرارة بالمنظار: دراسة استعادية لمدة ثلاث سنوات

Author: DILDAR HAJI MUSA دلدار حاجي موسى
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2018 Volume: 12 Issue: 2 Pages: 81-91
Publisher: University of Dohuk جامعة دهوك

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Abstract

ABSTRACTBackground and Objectives: Laparoscopic cholecystectomy has made a revolution in themanagement of symptomatic gallstone diseases. It has been widely accepted as a surgicalintervention for gallstone and cholecystitis. The spectrum of complications following thepresentation of this new minimally invasive surgical technique has been changed.In thepresent retrospective study, immediate, early, and late laparoscopy242 patients underwent laparoscopic cholecystectomy for symptomatic gallstone diseasesover three years were critically and clinically evaluated.Subject and Method: In a retrospective study, the complications of 242 patients under wentlaparoscopic cholecystectomy were reviewed clinically and critically.Results From January 2015 to January 2018, 242 patientscholecystectomy for the symptomatic gallstone disease. The mean age of the patients was40.12 year. Six patients were found with immediate bleeding, two caseswith postcholangitis due to passed stone, two patients with late port site hernia, and one case with subhepatic collection (abscess), and three cases developed port site infection. The conversion toopen surgery was found in three patients (1.24%) only.Conclusions: The surgeons need to select their patients carefully, equip themselves with thefor a safe laparoscopic cholecystectomy

الخلفية والأهداف: استئصال المرارة بالمنظار قد أحدث ثورة في السيطرة على أمراض المرارة العرضية. لقد تم قبولاستئصال المرارة بالمنظارعلى نطاق واسع كتدخل جراحي في حالات حصوات المرارة والتهاب المرارة. تم تغيير سلسلةالمضاعفات بعد تقديم هذه التقنية الجراحية الجديدة الأقل اجتياحا. في الدراسة الاستعادية الحالية، تم تقيم المضاعفات الأنية والمبكرة والمتأخره المتعلقه باستعمال المنظار في 242مريض يعاني من حصوات المرارة العرضي تم تنظيريهم وخضعهم لأستصال المرارة على مدى ثلاث سنوات تم تقييمهابشكل نقدي وسريريا.طرق البحث: في دراسة استعادية ، تم استعراض المضاعفات السريريا الخطيرة ل 242 مريض استئصلت مراراتهمبالمنظار لأمراض الحصوة المرارية.النتائج: من يناير 2015 إلى يناير 2018 ، خضع 242 مريض لأستئصال المرارة بالمنظار لأمراض الحصوة المرارية.كان متوسط عمر المرضى 12,40 سنة.تم العثور على ستة مرضى مع نزف طفيف على الفور، حالتين التهاب الأقنية الصفراوية بعد العملية بسبب الحجر الذيتم تمريره، واثنين من المرضى الذين يعانون من فتق متأخر في موقع القصطرة البوابية، وحالة واحدة تطورت الى خراجتحت الكبد و ثلاث حالات التهاب جروح فتحات الناظور.الاستنتاجات: يحتاج الجراحون إلى اختيار مرضاهم بعناية، وتجهيز أنفسهم بالمعرفة المطلوبة لأجراء النموذجي المرتبطفي المضاعفات ، واختيار أفضل و أمن طريقة لعلاج المرارة وأستئصالها بالمنظار.


Article
Role of Laparoscope in Abdominal Trauma

Authors: Abdulrazzak kalaf Hassan --- Hussein M. Ali Diaa Zainny
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2019 Volume: 12 Issue: 1 Pages: 4068-4076
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Use of laparoscopy in trauma is in general limited for diagnostic purposes; we aim to evaluate the therapeutic role of laparoscopic surgery in trauma patients. Laparoscope could be safe and effective in the treatment of patients with abdominal trauma.Aims of the Study: To identify the following:1.Benefits of Laparoscope in Abdominal Trauma. 2.Contraindications for Laparoscope in Trauma Patients. 3.Indications for conversion (from laparoscopic to open approach).Patient and methods: Forty patients with abdominal trauma, whether penetrating or blunt who was admitted to the casualty unit in Imam Hussein Medical City in The Holy Karbala City from Jan 2016 to June 2016 and were diagnosed as cases of acute abdomen by clinical examination base some were in shock state and unstable, admitted immediately to theatre, laparotomy was done to them. Other cases in shock, but corrected undergone surgery for different causes, some of them undergone purely laparoscopic interference by laparoscopic device under the name (KARL STORZ—ENDOSKOPE), other patients undergone conversion for different causes.Results: Forty were included in a prospective study who were undergone surgical intervention either in the form of traditional laparotomy or diagnostic laparoscopy eight (20%) of them undergone exclusive laparoscopic interference while nine (22.5%) undergone conversion, other twenty- three (57.5%) undergone open approach.Conclusions: From our study, we concluded that:1.A laparoscope is an important tool in the management of blunt abdominal trauma. 2.A laparoscope is a good preventive measure of nontherapeutic laparotomies. 3.It’s an important measure in diagnosing and even treating diaphragmatic injuries.4.Traumatic bowel injuries can be diagnosed and even treated by the laparoscope 5.The presence of profuse hemorrhage make continue on the laparoscopic approach is non judges.


Article
Outcome of laparoscopic cholecystectomy in acute and chronic cholecystitis

Author: Omar S. Khattab
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2010 Volume: 52 Issue: 3 Pages: 262-265
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: laparoscopic cholecystectomy is standard treatment in gallbladder disease. Acute cholecystitis has been relative contraindication of laparoscopic cholecystectomy. With the accumulation of experience in laparoscopic surgery, laparoscopic cholecystectomy is being gradually applied for the treatment of acute cholecystitis .Objective: to evaluate and compare the outcome of laparoscopic cholecystectomy in acute and chronic cholecystitis in terms of complications, conversion rates, reason of conversion, need for special modifications of the operative technique, and hospital stay.
Methods: A prospective study done Between April 2007 and January 2010, in the department of general surgery, medical city teaching hospital, Baghdad. Evaluation of all patients admitted with symptomatic gall bladder disease, who underwent laparoscopic cholecystectomy were included in this study. They were classified as group A (having acute cholecystitis) and group B (having chronic cholecystitis), The diagnosis of AC was based on clinical, ultrasonographic, and operative finding; also histological diagnosis.
Results: A total of 197 patients. 46 (23%) had acute cholecystitis (group A) while 151 patients (76.6%) had chronic cholecystitis (group B). In group A, Gall bladder decompression was required in 4 (8.7%) patients. One patient (2.2%) had wound infection, and one patient (2.2%) developed a subhepatic biliary collection. While epigastric port hernia occurs in one patient (2.2%). In group B, One patient (0.7%) had wound infection, and one patient (0.7%) had umbilical port hernia. Conversion rate was 3(6.5%) for group A and 0% for group B. There was no procedure related mortality in either group. The hospital stay (6-24 hours) was the same for both groups (group A; mean 9.13±6.89 hours, group B; mean 15.77±8.99 hours).
Conclusion: laparoscopic cholecystectomy is safe in all patients presented with symptomatic gall bladder disease.


Article
FABRICATION AND CHARACTERIZATION OF HIGH EFFICIENTCd O/SI PHOTOVOLTAIC SOLAR CELLS

Author: Khalid Z. Yahiya
Journal: Al-Nahrain Journal of Science مجلة النهرين للعلوم ISSN: (print)26635453,(online)26635461 Year: 2008 Volume: 11 Issue: 1 Pages: 56-58
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

In the present work, CdO/Si heterojunction solar cell has been made by vacuum evaporation of CdO thin film onto monocrystalline silicon substrate. XRD was investigated, the transmission was determined in range (400-1000)nm and the direct band gap energy is 2.5 eV, I-V characterization of the cell under illumination was investigated , the cell shows an open circuit voltage (VOC) of 0.4 V, a short circuit current density (JSC) of 40 mA/cm2, a fill factor (FF) of 0.34, and a conversion efficiency (η) of 5.5%.

في هذا البحث ، تم تصنيع خلايا شمسية هجينة نوع CdO/Si وذلك بتبخير أغشية CdO الرقيقة على قواعد سليكونية أحادية البلورة . تم دراسة البناء البلوري للغشاء بواسطة حيود الأشعة السينية وتم دراسة النفاذية للمدى (400-1000)nm تم حساب فجوة الطاقة المباشرة وتساوي (2.5)eV وتم دراسة القياسات تيار-جهد في حالة الإضاءة أبدت الخلية أداء فولطائي جيد حيث أن تيار دائرة القصر (40)mA/cm2 وان فولتية الدائرة المفتوحة (0.4)V وبكفاءة تحويل 5.5% وعامل ملئ 0.34 .

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