Tehran University Medical Journal

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This is a morbidity study about vascular trauma in Sina hospital, from 1974 to 1999. In this study morbidity is defined as amputation, wound infection, and recurrent thrombosis.
Materials and Methods: We reviewed the Patient's records and studied the effects of different factors such as type of trauma, associated injury, absence of capillary filling and presence or absence of distal pulse before and after surgery on morbidity.
Results: Reviewing 100 cases, we found 83 percent of them were thrombosis. The mean age was 32.5 years old. From the patients, 76 percent had penetrating trauma and the reminder had blunt traumas. Type of blunt trauma, associated injury, absence of capillary filling and the status of distal pulse, before and after surgery, time of surgery, muscular response to cautery and duration of hospital stay, all were associated with morbidity (P < 0.05).
Conclusion: In this study it is concluded that prompt diagnosis of vascular injuries, primary resuscitation and transferring the patients to proper centers and appropriate care of complicated cases, will help us to reduce morbidity.

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Background: Identifying risk factors for conversion to open surgery laparoscopic cholecystectomy and factors are difficult to predict cholecystectomy surgery is required. The aim of this study was to evaluate the findings of preoperative ultrasound in predicting the length of laparoscopic cholecystectomy surgery.
Methods: The present study was performed cross-sectional on 122 patients who underwent laparoscopic cholecystectomy in Shahid Beheshti, Forghani and Nekoei’s Hospital in Qom from September 2016 to September 2017.
Inclusion criteria: All cases of acute cholecystitis, chronic cholecystitis, symptomatic gallstones and biliary pancreatitis underwent laparoscopic cholecystectomy. The exclusion criteria included patients undergoing laparoscopic cholecystectomy at the same time were other procedures. Before surgery patients' information such as age, sex, ultrasound findings including gallbladder wall thickness, compressed stone and the presence of fluid around the gallbladder were recorded in the checklist. Finally, the duration of cholecystectomy was divided into two degrees of easy operation (less than 60 minutes and without complications) and difficult operation (above 60 minutes with complications) according to the mentioned variables. Data were analyzed by SPSS software, version 22 (IBM SPSS, Armonk, NY, USA). In this study, a significance level of less than 0.05 was considered.

Results: 28 (22.4 percent) males and 97 (77.6 percent) females with a mean age of 44.66 13 13.85 years were studied. There were 35 difficult cases (28 percent) and 90 easy cases (72 percent). Conversion to open surgery occurred in three cases. Among the sonographic findings, there was a significant relationship between the increase in gallbladder wall thickness and Impacted stone with the duration of operation (P≤0.05). But no significant relationship was found between the findings of Presence of pericholecystic fluid and the duration of operation (P>0.05). Conclusion: Overall, the findings of this study showed that preoperative ultrasound is able to provide valuable data in predicting the duration of laparoscopic cholecystectomy.