1. Intraoperative cholangiography during Laparoscopic cholecystectomy in the GrandMed Hospital
Bulgan CH ; Batkhuu A ; Enkhbayar D ; Altankhuyag B ; Saruul E ; Mishigdorj L
Journal of Surgery 2016;19(1):19-22
Introduction: In gallstone diseases,common bile duct stones and thickened bilecould cause hepatitis or other difficulties.Therefore intraoperative cholangiography ishelpful in many operations besides detectingand diagnosing the gallstones in commonbile duct.Materials and Methods: Out of 266patients who had undergone LaparoscopicCholecystectomy surgery in GrandMedHospital, 14 patients were found to havejaundice and cholestasis after undergoinglaboratory and radiology tests.Results: These 14 patients have allundergone IOC. 7 out of 14 patients werefound to have positive cholangiogram andthe other 7 - negative. Biliary tract tumorand anatomic anomalies were not identifiedamong these patients.Conclusion: Making analysis usingonly laboratory data is not adequate fordirectly detecting choledocholithiasis. IOCnot only shows bile tract obstruction anddetermines cholestasis causes, but it alsoidentifies the anatomy biliary tract, whichis a procedure that facilitates dissection.Therefore IOCcan prevent the most seriouscomplication of laparoscopic cholecystectomy- common bile duct injury. The sensitivityof IOC ensures the gathering of importantinformation on time, so suggest to use it forevery suspicious case.
2. RARE CASE OF RIGHT SIDED TRAUMATIC DIAPHRAGMATIC HERNIA IN GRAND MED HOSPITAL
Mishigdorj L ; Enkhbayar D ; Altankhuyag B ; Bulgan CH
Journal of Surgery 2016;19(1):74-76
Summery For TDHDiaphragmatic rupture is a lifethreateningcondition. Diaphragmaticinjuries are quite uncommon and oftenresult from either blunt or penetratingtrauma. Diaphragmatic ruptures are usuallyassociated with abdominal trauma however,it can occur in isolation. Acute traumaticrupture of the diaphragm may go unnoticedand there is often a delay between the injuryand the diagnosis. A comprehensive literaturesearch was performed using the terms“delayed presentation of post traumaticdiaphragmatic rupture” and “delayeddiaphragmatic rupture”. The diagnosticand management challenges encounteredare discussed, together with strategies fordealing with them.In our hospital, we had one patientwho has been diagnosed as a TDH. Wewerefocused on mechanism of injury,duration, presentation and site of injury,visceral herniation, investigations anddifferent approaches for repair. We intendto do a laparoscopic repair, but it diagnosedas a TDH so we did open Laparotomy.
3.Intraoperative cholangiography during Laparoscopic cholecystectomy in the GrandMed Hospital
Bulgan Ch ; Batkhuu A ; Enkhbayar D ; Altankhuyag B ; Saruul E ; Mishigdorj L
Journal of Surgery 2016;19(1):19-22
Introduction: In gallstone diseases,
common bile duct stones and thickened bile
could cause hepatitis or other difficulties.
Therefore intraoperative cholangiography is
helpful in many operations besides detecting
and diagnosing the gallstones in common
bile duct.
Materials and Methods: Out of 266
patients who had undergone Laparoscopic
Cholecystectomy surgery in GrandMed
Hospital, 14 patients were found to have
jaundice and cholestasis after undergoing
laboratory and radiology tests.
Results: These 14 patients have all
undergone IOC. 7 out of 14 patients were
found to have positive cholangiogram and
the other 7 - negative. Biliary tract tumor
and anatomic anomalies were not identified
among these patients.
Conclusion: Making analysis using
only laboratory data is not adequate for
directly detecting choledocholithiasis. IOC
not only shows bile tract obstruction and
determines cholestasis causes, but it also
identifies the anatomy biliary tract, which
is a procedure that facilitates dissection.
Therefore IOCcan prevent the most serious
complication of laparoscopic cholecystectomy
- common bile duct injury. The sensitivity
of IOC ensures the gathering of important
information on time, so suggest to use it for
every suspicious case.
4.A Comparative Study of Traditional And Conventional Treatment Of Chronic Pyelonephritis
Enkhbayar M ; Enkhjargal D ; Amarzaya D ; Sarantsetseg G ; Burmaa B ; Munkhzul D ; Khishigjargal S
Journal of Oriental Medicine 2012;3(2):8-8
Abstract The aim of this study is to compare the effects of traditional and conventional treatment of chronic pyelonephritis. Total of 100 patients diagnosed with chronic pyelonephritis were enrolled in the study. Traditional medicines included following: Sugmel-10, Sarichun, Yuna-4, Sema-3, and Sojid-11. Conventional medicines included following: ciprofloxacin, cefasolin, and negram. After 10-14 days of treatment questionnaire, physical examinations, and laboratory tests were performed. In 90% of patient treated with traditional medicines, changes of smell and color of urine was disappeared. Back pain and dysuria was reduced in 89.7% and 75% of patients respectively. While in control or conventional treatment group, changes of smell and color of urine was completely disappeared and back pain and dysuria was reduced in 80% and 88% of patients respectively. Pasternatskii’s symptom and arterial hypertension was reduced in about 58% and 77% of patients respectively. Bacterial growth (Escherichia coli and Staphylococcus aureus) was ceased in 39.4% and reduced in 46.4% of patients treated with traditional medicines. It was ceased in 60% and reduced in 30% of control patients.Traditional medicines reduced signs and symptoms of chronic pyelonephritis. Bacterial growth was ceased or reduced by traditional treatment. Traditional medicines are effective as conventional medicines for treatment of chronic pyelonephritis.