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 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.
2. 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.
3. TRANSFORAMINAL PERCUTANEOUS ENDOSCOPIC DISCECTOMY FOR LUMBAR DISC HERNIATION AND NERVE ROOT DECOMPRESSION FIRST TIME IN MONGOLIA
Temuujin M ; Saruul E ; Nurbyek B ; Mishigdorj L ; Bulgan CH ; Sergelen O
Journal of Surgery 2016;20(2):92-95
Introduction: Various modalities oftechniques from standard discectomy,microdiscectomy, percutaneous discectomy,and transforaminal endoscopic discectomyhave been in use for lumbar intervertebraldisc prolapse1. The access to spine is keptto a minimum without stripping paraspinalmuscles minimizing muscle damage bytransforaminal endoscopic approach2.Currently in the population of the Mongoliabeen increased of the spinal nerve rootcompression, which are resulting in lumbardisc pathological changes. In other developedcountries has been successfully introducingthe spine endoscopic surgery use for thatpathological changes. In regard to our countryhad not yet implemented for until now asthese high technological surgeries3. Spinesurgery department team of the GrandMedhospital had successfully introduced that thespine endoscopic surgery.Materials and Methods: We performedtransforaminal endoscopic lumbardiscectomy surgeries on patients age of 24,38, 78 on July/23/2016 All patients withsingle nerve root compression due to Lumbardisc herniations, including sequestrated ormigrated and selected central disc at L4-5. All patients had preoperative MRI andpostoperative MRI to check the adequacy ofdecompression. All patients were operatedby 18-mm ports of the S-Gun endoscopicequipments. Procedure had done under localanesthesia. Postoperatively, all patients weremobilized as soon as the pain subsided anddischarged within 24-48 h post-surgery.Patients were followed up at 2, 6 weeks.Results: The mean follow up was 2-6weeks. The average surgical time was 70min (range 25-210 min). Average blood losswas 20-30 ml. Postoperative MRI showedcomplete decompression. All of patients hadgood-to-excellent results and straight raisingleg test (Lasegue) were 90/90 respectively.All patient is preoperatively visual analogyscale was 8±1 and then became to 1±1.Conclusion: Microendoscopic discectomyis minimally invasive procedure fordiscectomy with results of this procedure areacceptable safe and effective. However, forthis technique has required to do accuracyand experienced surgeon.
4.Risk factors profile for cardioembolic stroke: A case-control study
Uurtsaikh G ; Batmyagmar K ; Dosjan E ; Saruul Ts ; Ariyasuren L ; Nandintsetseg B ; Baasanjav N ; Lkhamtsoo N
Mongolian Medical Sciences 2021;196(2):13-20
Introduction:
In Mongolia, data on the etiology and risk factors of cardioembolic stroke (CES) is scarce and few
clinical studies have been performed to date. Timely identification and control of cardiovascular risk
factors are priority objectives for adequate primary and secondary prevention of CES.
Goal:
The goal of this study was to describe risk factors for CES in our setting.
Results:
The case-control study enrolled a total of 525 subjects. CES was detected in 63 (35.7%) out of
176 (33.5%) ischemic stroke patients with a predominance in age group of 60-69 and men (33%).
The main risk factor of CES was non-valvular atrial fibrillation (AF). AF especially paroxysmal AF
increased the risk of CES by 4.6 times (p=<0.0001, OR 4.6, 95% CI 1.4-44.6). The second main
cerebrovascular risk factors were hypertension and dyslipidemia.
Conclusion
CES accounted for 1/3 of ischemic stroke. The commonest underlying medical conditions were non-valvular atrial fibrillation, hypertension, dyslipidemia, alcohol consumption and obesity. Hence, all
patients with hypertension and non-valvular AF should be meticulously screened for prevention of
CES.