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    Laparoscopic Cholecystectomy Results In Patients With Different Age Groups
    (Derman Medical Publ, 2011) Yetim, Ibrahim; Dervisoglu, Adem; Karakose, Oktay; Buyukkarabacak, Yalcin; Bek, Yuksel; Erzurumlu, Kenan
    Aim Laparoscopic cholecystectomy (LC) has been most preferable method for benign gallbladder disease. Advanced age may be increased morbidity and mortality. The aim of this study was to compare the results of LC in patients according to different ages (age <= 30, 31 -64 years, and age >= 65). Material and Methods A retrospective analysis was performed including overall 511 patients who underwent LC for benign disease of gallbladder at Ondokuzmayis University Medical Faculty and Mustafa Kemal University, Medical Faculty between November 2001 and November 2009. The patients are divided into three groups according to ages: Group A (age <= 30 years, n = 47), Group B (age = 31 -64 years, n = 368), Group C (age >= 65, n = 96). Results Symptomatic cholelithiasis was the most common indication for LC in all the groups (p > 0.05). Co-morbid diseases were significantly higher in the Group C (>= 65 years) than in the Group A and B (<= 30 years, 31 -64 years) (p= 0.001). Co-incidental biliary pathologies, and history of abdominal operation were similar in all the groups. However biliary duct and cystic artery anomalies were significantly more common in the Group A than in the Group B and C (p= 0.001). Conversion to OC was required in 26 (5.08 %) patients in this study. The major reason for the (21 cases, 80.76 %) was difficult dissection of the Calot's triangle. There was no difference in morbidity among the groups (p> 0.05). Conclusions As a conclusion, it's thought that biliary anomalies in young patients and co-morbid diseases disorders in elderly patients are more common. These factors do not affect the results of patient that preoperatively well evaluated. However surgeon should be aware of this condition and be careful for intraoperative and postoperative complication.
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    Praziquantel-Dymethylsuifoxide Solution: The Side Effect on Hepato-biliary System (An Experimental Study)
    (Derman Medical Publ, 2010) Yetim, Ibrahim; Buyukkarabacak, Yalcin; Erzurumlu, Kenan; Dervisoglu, Adem; Hokelek, Murat; Baris, Sancar; Bek, Yuksel
    Aim In this experimental study, the side effects of praziquantel and dymethylsulfoxide on the hepatobiliary system has been investigated comparing with alcohol, hypertonic and normal saline. Material and Methods This study contains five groups of ten rats each. In all groups, transduodenal choledochal cannulation was done and either dymethylsulfoxide, praziquantel in dymethylsulfoxide solution,0.9 % NaCI, 20 % NaCI or 98 % alcohol were injected. Before surgery, blood samples were taken for measuring AST, ALT, ALP, GGT levels, and repeated every months for three months period. At the end of study, all rats were sacrificed; hepatobiliary excision was done. Results Biochemical content and blood samples have not statistically significant difference at the beginning of the study. After protoscolocidals injection into common bile duct, ALT, AST and ALP levels were siginificantly found higher at hypertonic saline group than control's (p<0.05). GGT level in hypertonic saline group was similar to control's. Also allthe biochemical results were siginificantly higher at dymethylsulfoxide, praziquantel in dymethylsulfoxide solution and alcohol groups than hypertonic saline and control groups (p<0.05). Although ALT, AST and ALP levels were found highest in hypertonic saline group; GGT level were was highest in dymethylsulfoxide group, (p<0.05) (Figure 1, 2, 3, 4). Histopathological research has shown that hepatoceluler changes were siginificantly higher in hypertonic saline group than control group, (p<0.05) Also it was higher in alcohol, dymethylsulfoxide and praziquantel in dymethylsulfoxide solution groups than the others, (p<0.05) Although dymethylsulfoxide and hypertonic saline have similar side effects on biliary tract; praziquantel in dymethylsulfoxide solution solution has stronger side effect then them, (p<0.05) alcohol has strongest side effect on biliary tract, (p<0.05). Conclusions As a conclusion, it is thought that praziquantel in dymethylsulfoxide solution solution has similar risk to alcohol and more than hypertonic saline on hepatobiliary tract in intraoperative use for hepatic hydatidosis.
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    Shouldice Herniorrhaphy Technique: Surgeons Need to Remember It
    (Derman Medical Publ, 2012) Yetim, Ibrahim; Karakose, Oktay; Dervisoglu, Adem; Erzurumlu, Kenan
    Aim: Hernia surgery is the second most common surgical intervention performed by general surgeons following emergent surgeries. Shouldice herniorraphy is a classical surgery which is in the high tension repair group. This technique should be known by every surgeon. Also being an alternative method, it can be a necessity in cases in which tension free methods can not be performed. In the present study we investigated the advantages, disadvantages and complications of the Shouldice herniorraphy and Lichtenstein technique with the review of the technical literature. Material and Method: We compared 75 patients who were diagnosed with inguinal hernia and treated with Lichtenstein herniorraphy with 33 patients who were treated with Shouldice herniorraphy in Samsun Bafra Public Hospital between April 2007 and May 2008. Age, sex, hernia type, anesthesia method, mean hospitalisation length, early and late post operative complications were recorded. Result: Early post operative complications were urinary retention, wound infection and hematoma. The patients under spinal anesthesia with urinary retention were treated with urinary catheterization. Superficial wound infection was treated with drainage and antibiotic threapy. Among late postoperative complications; we observed paresthesia in the thigh in one patient in the Shouldice group and relapse hernia in one patient in the Lichtenstein group. Discussion: We suggest that this surgical technique which should be known by every surgeon should be taught to new surgery attenders as an alternative technique. This technique can be an alternative method and also may be the first choice in patients in whom tension free methods can not be applicated.