Print ISSN: 2790-0207

Online ISSN: 2790-0215

Keywords : Laparoscopy

Laparoscopic Gastric Plication; Comparative Study between Modified Enteric Bypass and Loop Bipartition

Herish M. Kanabi; Abdulqadir M. Zangana

Kirkuk Journal of Medical Sciences, 2019, Volume 7, Issue 1, Pages 19-27

Background: Laparoscopic gastric plication (LGP) is emerging as a safe and effective bariatric procedure. A comparative study between the efficacy and complications of LGP with modified enteric bypass and LGP with loop bipartition, which are still an investigational bariatric procedure. The objective of this study to compare safety and efficacy of LGP with enteric bypass and LGP with loop bipartition in the treatment of morbid obesity in a one-year follow-up study. Methods: A prospective study between February 2016 to December 2017, conducted on 80 morbid obese patients who were candidates for laparoscopic gastric plication, with either loop bipartition or modified enteric bypass surgery were randomly assigned to receive either LGP modified enteric bypass (n = 40) or LGP with loop bipartition (n = 40). Early and late complications, body mass index (BMI), excess weight loss, and obesityrelated co-morbidities were determined at the 1-year follow-up. Results: Operative time and mean length of hospitalization were shorter in the LGP with modified enteric bypass group than LGP with loop bipartition; (110 minutes versus 120 minutes, P<.001, and 2 days versus 3 days; P<.001, respectively). The mean percentage of excess weight loss (%EWL) at 12 months follow-up was (79.5%) in the LGB with modified enteric bypass group and (74.1%) in the LGP group (P = 0.03). Improvement was observed in all co-morbidities in both groups. Conclusion: Both LGP and LGB are effective weight loss procedures. LGP enteric bypass proved to be a simpler and less costly procedure compared with LGP with loop bipartition with a lower risk of stomal ulcer during one year follow up.

The Role of Laparoscopy in the Treatment of Patients with Liver Hydatid Cyst in Kirkuk General Hospitals

Hazim Sadeq Ahmed; Isam Abas Alatar; Abdulkarem Omer Mohammed Salih

Kirkuk Journal of Medical Sciences, 2017, Volume 5, Issue 1, Pages 1-6

Background: Treatment of liver hydatid cystic disease rangse from surgical intervention (laparoscopic or conventional approach) to percutaneous drainage and to medical therapy. Objective: Evaluation the role of laprascopy in the management of liver hydatid disease. Methods: A total of 32 cases with liver hydatid cyst underwent laprasopic management in Kirkuk general hospital from January 2010 to December 2015. Age, sex, duration of surgery, surgical morbidity, and evidence of hydatid cyst recurrence were measured. Results: Laproscopic management done for 918) male (56%) and (14) female (44%) with liver hytatid cyst, with mean age of (35 years). The number of cysts were either single (68.8%) or to maximum 2 cyst (31.2%), with size range (4-14 cm). patients presented with either pain (53.1%), nausea or dyspepsia (9.4%), accidentally found on u/s (9.3%), and jaundice (3.1%). The most common complication was associated with cyst size of ≥ 6 cm: bile leakage (53.1%), peritonitis (3.13%), port site infection (3.13%). Conclusions: laparscopic approach of liver hydatid cyst is a tolerable and safe procedure.

Role of Laparoscopy in the Diagnosis of Abdominal Tuberculosis in Patients with Vague Abdominal Symptoms

Dler Omer Mohammed; Loay Shihab Ahmed; Amanj Mohammed Salih

Kirkuk Journal of Medical Sciences, 2014, Volume 2, Issue 2, Pages 8-14

Background and Aim: Tuberculosis continues to be a common disease in Iraq and one of its presentations is abdominal tuberculosis which tends to present with non-specific features that can be hard to diagnose at times. Histopathological confirmation of abdominal tuberculosis is difficult because of suboptional, noninvasive access to the pathology. The aim of this study was to find out the efficacy of diagnostic laparoscopy in establishing the histopathological diagnosis of abdominal tuberculosis. Patients and Methods: A retrospective study conducted on 67patients with vague abdominal pain, with or without ascites, for whom diagnostic laproscopy was performed in Azadi Teaching Hospital in Kirkuk City over a period of six years (January 2007 - December 2012). Data were collected and statistically analyzed using SPSS software version 16. Results: A total of (67) patients with vague abdominal symptoms and an unsettled diagnosis were included in this study, of which 22(32.8%) of the patients were diagnosed with abdominal tuberculosis on laparoscopy. The common symptoms were abdominal pain, changing bowel habits, loss of weight, fever and generalized weakness. The most consistent laboratory finding (>86%) was a high ESR. Macroscopic findings of abdominal tuberculosis were whitish granulations over both peritoneal layers, inflammatory adhesions on the visceral or parietal surface, thickening, hyperemia and retraction of the greater omentum and stalactic band which is characteristic of abdominal tuberculosis. Direct visualization of the peritoneum and obtaining peritoneal biopsies provided the definitive tissue diagnosis to confirm the clinical diagnosis. Conclusion: Although other diagnostic methods of abdominal tuberculosis such as imaging, culture of ascites and polymerase chain reaction (PCR) are used today, laparoscopy with tissue biopsy provided efficient and reliable diagnostic tool for patients suspected with abdominal tuberculosis. Patients were saved from unnecessary laparotomies and were managed on anti-tuberculosis drug therapy.