No abstract

Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversions to open cholecystectomy are still inevitable in certain cases. Knowledge about the rate and underlying reasons for conversion could help surgeons during preoperative assessment and improve the informed consent of patients. We decide to review the rate and causes of conversion of our LC series. This study included 320 consecutive laparoscopic cholecystectomies from January 2017 to December 2019 at Community Based Medical College Hospital Bangladesh, Mymensingh. All patients had surgery performed by same surgeon. Conversion to open cholecystectomy required in 15 (4.6%) patients. Out of 15 cases, the highest number of patients 10(66.6%) were in age group 50 to 59 years with a mean age of 60.1 years and standard deviation (SD) of 9.8 years. Of them 9 (60%) were male. The most common reasons for conversion of them were severe adhesions at calot's triangle 6 (40%) and acutely inflamed gallbladder 5 (33.3%), bleeding 2 (13%). No surgical procedures are complication free. The most common complication was superficial wound infection 8(2.5%). Delayed complications seen in our series is port site incisional hernia 2 (0.62%). Male gender, age older than 60 years, previous upper abdominal surgery, diabetes, and severity of inflammation were all significantly correlated with an increased conversion rate to laparotomy. LC is the preferred method even in difficult cases. This study emphasizes that although the rate of conversion to open surgery and complication rate are low in experienced hands, the surgeons should keep a low threshold for conversion to open surgery. CBMJ 2020 July: Vol. 09 No. 02 P: 14-18

Objectives: To compare

Objective: To compare the outcome of optical internal urethrotomy (OIU) with or without intralesional triamcinolone acetonide injection for the treatment of short segment anterior urethral stricture. Methods: This prospective quasi experimental study was carried out in the department of Urology, DMCH, Dhaka from November 2015 to April 2017 on 50 patients with short segment of anterior urethral stricture. Cases were randomly allocated to group A (OIU without Triamcinolone) and group B (OIU with Triamcinolone). Each group consisted of 25 patients. Data were analyzed and compared by statistical tests. Results: There were no significant differences in the baseline characteristics of the patients. Recurrences of stricture urethra were higher among those without Triamcinolone than cases with Triamcinolone which was statistically significant (p=0.033) at 6 month and (p=0.016) at 9 months. Regarding mean time interval in month of development of recurrence of stricture was 6.1±1.66 months in Group A and 7.66±1.52 months in Group B which was statistically significant (p=0.001) Conclusion: OIU with intralesional triamcinolone is better than OIU alone. It significantly reduced and delayed the recurrence of anterior urethral stricture. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 126-130

Background: Radical prostatectomy is the best treatment option for clinically localized prostate cancer. But oncological as well as functional outcomes of this procedure including incontinence and erectile dysfunction are a big challenge for the surgeon. Objectives: This paper has focused on our initial experiences of oncological and functional outcomes of open radical retropubic prostatectomy. Materials and methods: Total five cases underwent open radical retropubic prostatectomy between January'2016 to October' 2017. All patients had clinically organ confined prostatic adenocarcinoma. Open radical retropubic prostatectomy with bilateral pelvic lymph node dissection was done through a lower midline incision. We observed the surgical experiences and assess the oncological and functional outcomes postoperatively. Results: The median age (range) of patients at diagnosis was 63 (56-72) years. The median Gleason sum (range) was 7 (6-9) and mean pretreatment PSA was 16.2±5.4 ng/ml. There was no perioperative mortality and no major complications in immediate postoperative period. Final pathological specimen shows negative surgical margin in all cases but one patient has positive unilateral lymph nodes. One patient achieved continence within 3 months; three patients achieved continence at 6 months, one patient after one year. Two patients had satisfactory erection at 6 months; onepatients are at 9 months, and two patients could not gain erection after one year. Conclusion: Though open radical retropubic prostatectomy is tough procedure due to its difficult access to the surgical field. Oncological and functional outcome is totally depending on the skill of the surgical team. KYAMC Journal Vol. 9, No.-4, January 2019, Page 166-169