Biomedical subjects

Salam Daradkeh

Publications and source records attributed to Salam Daradkeh.

4 recordsLinked to original sources

PubMed2006

Predictors of morbidity and mortality in the surgical management of hydatid cyst of the liver.

BACKGROUND/AIMS: Surgery for hydatid cyst of the liver is widely practiced worldwide; this type of management is still associated with high mortality and morbidity. The aim of this study is to find out possible predictors for this high mortality and morbidity. MATERIALS AND METHODS: The medical records of 169 patients who underwent surgery for hydatid cyst of the liver were retrospectively reviewed. The mortality and the morbidity rates were assessed as well as the following eight potential predictors of mortality and morbidity: age of the patients, size of the cyst, number of cysts, other organs involved by the disease, the presence of preoperative complications, the type of surgery performed (radical or conservative), whether the disease was new or recurrent, and when surgery was performed in the first period (1973-1986) or in the second period (1987-1999). Cross-tabulation and logistic regression between mortality and morbidity (dependent variable) and the above-mentioned eight potential predictors (independent variables) were carried out. RESULTS: Of the 169 patients, 112 were female subjects and 57 male subjects, the age range was from 5 to 85 years (mean=39.2 years), the mortality rate was 6.5% (n=11), and the overall morbidity rate was 53.8% (n=91), while specific complications of liver hydatid cyst surgery were seen in 32% (n=54). Patients of age >40 years, with a cyst diameter of >10 cm, who presented with pre-operative complications, who had conservative surgery, and who had surgery before 1987 were having a significantly higher mortality and morbidity rate. CONCLUSION: Age, size of the cyst, the presence of pre-operative complications particularly cyst-biliary communication, and type of surgical procedure performed (conservative or radical) represent as significant predictors of mortality and morbidity of surgery for liver hydatid cyst.

Adolescent↗

PubMedDate not supplied

Transjugular preoperative portal embolization (TJPE) a pilot study.

BACKGROUND/AIMS: Because of our previous experience with transjugular intrahepatic portosystemic shunt, we decided to apply the transjugular approach to preoperative portal embolization. The aim of this pilot study was to determine the feasibility and the potential advantages and disadvantages of this new method. METHODOLOGY: Under ultrasound guidance the right or left portal branch was punctured from the right, median or left hepatic vein. Then, a catheter was placed near the portal bifurcation and used to perform right portal branch embolization with a mixture of Histoacryl and Lipiodol. Pre- and post-transjugular preoperative portal embolization duplex ultrasound and CT scan were performed to assess portal flow and liver tissue growth. Hospital stay, pain and hepatic enzymes were monitored. RESULTS: Fifteen patients underwent a transjugular preoperative portal embolization without any serious complication. Mean of hospital stay was 3.3 +/- 0.6 days. (2-5 days). Portal embolization was successful in all cases; left portal branch velocity increased from 11.8 +/- 7.5 cm/s before, to 16.5 +/- 3.5 cm/s on day one, and 14.8 +/- 3.3 cm/s on day 28 after transjugular preoperative portal embolization; volume of non-embolized segments increased by 10% within the 4 weeks after transjugular preoperative portal embolization. Right hepatectomy was possible in 12 patients CONCLUSIONS: This method is safe, painless, and can be proposed in cases of impossibility to perform the standard percutaneous transhepatic portal embolization (tumor interposition, impaired hemostasis).

Aged↗

PubMedDate not supplied

Laparoscopic cholecystectomy: analytical study of 1208 cases.

BACKGROUND/AIMS: To review our experience and to compare it with similar series published in the literature with emphasis on the safety, the rate of conversion, the mortality and the morbidity of the procedure. METHODOLOGY: From January 1994 to February 2003, the files of 1208 cases of laparoscopic cholecystectomy were retrospectively analyzed; the technique of surgery as well as the associated co-morbid conditions, the rate of conversion to open cholecystectomy, and the morbidity and mortality was analyzed and compared to other series. Simple descriptive statistics were used. RESULTS: The average age was 47.2 +/- 15.1 years (4-94), there were 878 (72.7%) females and 330 (27.3%) males. Of this series 20 patients underwent laparoscopic cholecystectomy while pregnant, 576 (48%) of the patients had co-morbid conditions. Conversion to open cholecystectomy was required in 32 (2.6%) cases and 25 (2.1%) patients had complications but no single biliary tract injury was noted. One patient died and his death was not directly related to the procedure. The average hospital stay was 2.8 (0.5-35) days. CONCLUSIONS: With patience and meticulous technique laparoscopic cholecystectomy in the third millennium is safer and quicker than open cholecystectomy. Our results compare favorably with those published to date.

Adolescent↗

PubMedDate not supplied

Factors affecting common bile duct diameter.

BACKGROUND/AIMS: The purpose of the study was to see the effect of age, sex, body mass index, previous cholecystectomy, hepatomegaly and fasting status on the common bile duct diameter. METHODOLOGY: A series of 463 patients, 283 females and 180 males, with no hepatobiliary or pancreatic pathology were included in this study, the mean age was 45 +/- 16 years. Their age, sex, weight, height, fasting status and previous cholecystectomy was assessed and recorded by a physician prior to ultrasound examination. All patients were examined by real-time ultrasound to see if there was any pathology in the hepatobiliary and pancreatic area. Those with history of common bile duct exploration, endoscopic sphincterotomy or with previous history of cholecystectomy of less than 6 months and patients with common bile duct pathology were excluded from the study. The midportion of the common bile duct was taken as a fixed measurement for all patients and the size of the liver was also recorded. Analysis of variance as part of SPSS statistical package was used where common bile duct was considered a dependent variable, while sex, fasting status, hepatomegaly and previous cholecystectomy were considered to be independent variables, age and sex were considered as co-variants. RESULTS: The factors found to be significantly affecting the diameter of the common bile duct (P<0.05) were age, previous cholecystectomy and body mass index. CONCLUSIONS: If the CBD dilatation can not be explained by age, previous cholecystectomy and BMI, a pathology causing obstruction should be ruled out.

Adult↗