Background  Laparoscopic cholecystectomy is a one of main surgical procedures that used widely for the treatment of symptomatic gallstones throughout the world. Although laparoscopic cholecystectomy has its own advantages, but bile duct injuries occur more frequently compared to the open cholecystectomy. In this study, critical view of safety (CVS) technique is compared to conventional infundibular technique (IT). Objectives  The aim is to compare critical view of safety with infundibular technique in laparoscopic cholecystectomy, in term of duration of the surgery and bile duct injuries (BDI). Methods Laparoscopic cholecystectomy was performed for 245 patients at Sulaimani city within a period from April 13th 2015 to April 13th 2016. The patients were divided into two groups; critical view of safety was used for the first group and infundibular technique for the second. Comparison performed between the both groups for operation time and bile duct injury. Results The operative time was significantly reduced in CVS technique as the mean time of the operations was (33.04 min) for CVS, and (38.58 min) for IT, with significant P-value (0.013). Seventeen cases (6.93%) converted to open cholecystectomy; the conversion found more in IT group, with significant P-value (< 0.001). Conclusion The “critical view of safety” although needs more patience in dissections with comparison to infundibular technique, but it is found to be faster and regard as a safe technique in laparoscopic cholecystectomy.

Background  Laparoscopic cholecystectomy has become the standard operative procedure for cholelithiasis, but there are still some patients requiring conversion to open cholecystectomy, mainly because of technical difficulty.  Objectives  To identify the prediction of difficult laparoscopic cholecystectomy. Materials and Methods Preoperative clinical, laboratory, and radiologic parameters of 249 patients, who underwent laparoscopic cholecystectomy, were analyzed for their technical difficulty. Parameters (male sex, abdominal tenderness, previous upper abdominal operation, sonographically thickened gallbladder wall, age over 65 years, preoperative diagnosis of acute cholecystitis, history of ERCP) were found to have significant effect in multivariate analysis. Results Overall 54 operations (21.7%) were difficult; 36 operations (14.5%) took long time and 18 patients (7.2%) required conversion to open cholecystectomy.  Conclusions Conversion risk can be predicted to some extent. Patients having high risk may be informed and scheduled appropriately. An experienced surgeon has to operate on these patients, and he or she has to make an early decision to convert in case of difficulty.

Prostate cancer is prevalent among men aged over 65 and has been reported as the fourth most common cause of mortality of males all over the world. In addition to age, family history, and race, there are some lifestyle features such as diet, obesity, alcohol, and smoking are believed to play a role in its development. The present study was carried out in order to examine the clinical and epidemiologic characteristics of castration-resistant prostate cancer patients identify predictive factors for development of resistance to hormonal therapy. The present retrospective cohort study was carried out on 150 patients who were diagnosed with prostate cancer at Hiwa Cancer hospital in Sulaimania, Iraqi Kurdistan over the period of 2009-2014. Required data were collected using face-to-face or phone interviews using a questionnaire and the patients’ hospital records. The collected data were analyzed using descriptive statistics, one-sample Kolmogorov-Smirnov test, independent samples t-test, Mann Whitney test, and Pearson’s Chi-square test through SPSS 20.0.

This is a multi-center retrospective study of patients underwent low anterior resection for rectal cancer. Ileostomy had been done to protect low lying Colo-rectal anastomosis, closure of ileostomy had been delayed in some patients due to patient own will, surgical complications (anastomotic leak) or coarse of chemotherapy. This study aimed to find the effect of temporary ileostomy on post-operative bowel defunction which is called Low anterior resection syndrome (LARS), and include; urgency, difficulty in emptying of bowel, and incontinence for feces and flatus.  A total of 50 patients included in this study, the age ranges from the 19 to 80 years old with a mean age of 51.96 years. The total number of males was (33, %66). Majority of patients were overweight (21, 42%). The distance of tumors from the anal verge were less than 10 cm in (31,62%). The mean duration of fecal diversion was 7.17 months. Loop ileostomy were closed before six months in (27,54%). The mean duration of diversion of patients developed no LARS was 6.87 months which is shorter than those of developed LARS (7.31). Lower BMI patients are more prone to develop LARS, while Obese patients are more susceptible to develop major LARS. Nineteen cases developed LARS among those patient’s ileostomy closed before six months, and 15 cases developed LARS in those ileostomies closed after six months.  

The aim of the study is to declare the role of surgery in potentially curative malignant pancreatic neuroendocrine tumors, in term of prognosis, survival and complications after the surgical procedures. Does the surgery plays a significant role in the best patient's interest even in metastatic pancreatic neuroendocrine tumors? Clinical and pathological factorsthat changed the outcomes were also analyzed. It is retrospective, case series study. All patients who were undergoing surgery for malignant pancreatic neuroendocrine tumors from 2013 to 2018. Results show that, sixteen patients were recruited with a mean age at diagnosis of 49.31 years, (ranging from 19-80 years). There were 8 male and 8 female patients. Common symptoms were abdominal pain 12 (75%) of them three cases had clinical jaundice 3 (18.8%) and one case had acute pancreatitis and pancreatic necrosis. One (6.3%) patient had functional tumor, and the rest 15 (93.8%) (P-value 0.027), lymph node metastases (P-value 0.027) and tumor stage (P-value 0.017) were associated with recurrent disease. The overall 5 year survival was 81.2% and the disease free survival was (75%) at 5 year, with grade of tumor (Pvalue 0.001), lymph node metastases (P-value 0.001), invasion of other visceral organs(P-value 0.018) and recurrence (P-value 0.001)were associated with decreased survival. In conclusion, pancreatic neuroendocrine tumors have favorable long-term survival after surgical resections even in the presence of liver metastases depending on the grade of differentiation of tumor and lymph node metastases rather than liver metastases and other factors. were nonfunctional tumors; all of the patients were sporadic pancreatic neuroendocrine tumors. Overall morbidity was (43.8%) with no perioperative mortality. The median follow-up period was 23 months, ranging from 5-68 months. Recurrence occurred in four cases with a median disease-free interval of 9.5 moths with grade of differentiation