BACKGROUND AND OBJECTIVES Maricopa Medical Center (MMC) was found to have higher charges and length-of-stays than 16 other regional hospitals in an analysis of DRG categories for gallbladder disease. These comparative figures identified MMC as being inefficient and demanded review to determine the reasons for the inefficiencies. METHODS In an attempt to determine the reason for inefficiency o...

Objective: To assess the rate and causes of conversion of laparoscopic to open cholecystectomy (OC) in 450 patients who underwent laparoscopic cholecystectomy (LC) by the same surgeon in tertiary care teaching hospitals. Study Design: Descriptive study. Place and Duration of Study: The study was conducted initially at Pakistan Navalship (PNS) Shifa, Karachi and later at Combined Military Hospit...

BACKGROUND Management of patients with severe acute cholecystitis (AC) remains controversial. In settings where laparoscopic cholecystectomy (LC) can be technically challenging or medical risks are exceedingly high, surgeons can choose between different options, including LC conversion to open cholecystectomy or surgical cholecystostomy tube (CCT) placement, or initial percutaneous CCT. We revi...

BACKGROUND Pre-operative prediction of a difficult laparoscopic cholecystectomy (LC) can help the patient as well as the surgeon prepare better for the intra-operative risk and the risk of conversion to open cholecystectomy. METHODS In 105 eligible patients who underwent LC during May 2001 to January 2003, patient characteristics, clinical history, laboratory data, ultrasonography results and...

INTRODUCTION Surgical site infection (SSI) comes as third most common healthcare related infection which produces morbidity and deaths at large. Still many authors believe that it is better not to use prophylactic antibiotics in simple and uncomplicated cases. Laparoscope, now-a-days is a much used instrument for abdominal surgeries. Even after new aseptic techniques SSI remains to be a major p...

OBJECTIVE To evaluate the outcome of laparoscopic cholecystectomy in acute cholecystitis and to determine various pre-operative risk factors predicting conversion to open cholecystectomy. DESIGN Observational study. PLACE AND DURATION OF STUDY Department of Surgery, Riyadh Medical Complex, Riyadh, Saudi Arabia over 5 years period from June 1, 1997 to May 30, 2002. PATIENTS AND METHODS Con...

UNLABELLED In 95 children (age 6-18 y) treated for gallstones between 2002-2010, 95 laparoscopic cholecystectomies were carried out. Symptomatic cholecystolithiasis was the indication for laparoscopic cholecystectomy in most of the cases. In three patients, there was a conversion to open cholecystectomy. Postoperative complications due to failure of bile drainage arose in three patients. Restor...

Objective The laparoscopic approach is the procedure of choice for cholecystectomy, but the cost of such an operation is very high because it needs expensive, special instruments Laparascopic cholecystectomy (LC) also has a higher risk of biliary injury when compared with conventional open cholecystectomy (COC). Open, minimally invasive cholecystectomy is an alternative procedure that comprises...

INTRODUCTION Situs inversus is a rare autosomal recessive condition associated with complete transposition of abdominal+/- thoracic organs. Surgical diagnosis and surgical procedures in patients with situs inversus is tricky because of the mirror image anatomy of intra-abdominal organs. MATERIALS AND METHODS A retrospective analysis of 2152 and 1497 patients who underwent laparoscopic cholecy...

Increasing numbers of patients require cholecystectomy after previous pneumonectomy, but there are little data to guide anaesthetic management. A laparoscopic approach is associated with less postoperative respiratory compromise than open cholecystectomy but may be relatively contraindicated due to the undesirable effects of pneumoperitoneum on respiratory function. We describe the case of a 72...