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Article: Outcomes of Open Versus Laparoscopic Technique in Primary Inguinal Hernia Repair: A Retrospective Study.

Alharthi, Mohammed / Almontashri, Alwa I / Alsharif, Raghad H / Mozahim, Sarah F / Alyazidi, Lujain K / Ghunaim, Mohammed / Aljiffry, Murad

Cureus

2023 Volume 15, Issue 10, Page(s) e46419

Abstract: Inguinal hernia repair is one of the most common surgical procedures worldwide. In clinical practice, there are two different routes to repair inguinal hernias: laparoscopic mesh repair and open. Reducing the hernia and preventing recurrence remains the ... ...

Abstract	Inguinal hernia repair is one of the most common surgical procedures worldwide. In clinical practice, there are two different routes to repair inguinal hernias: laparoscopic mesh repair and open. Reducing the hernia and preventing recurrence remains the mainstay treatment option of both procedures. This study aims to compare postoperative outcomes and recurrence rates for patients who had primary, non-recurrent, laparoscopic, or open hernia repair in a single tertiary hospital. A retrospective cohort study was done on 468 patients. The study was conducted at King Abdulaziz University Hospital (KAUH) between 2013 and 2022. The distribution of our study population was divided into open hernia repair 378 participants (80.8%) while the rest did laparoscopic hernia repair 90 (19.2%). Operation duration in minutes was 107.158 ± 41.402 in the open hernia repair group and was noted to be significantly higher in the laparoscopic hernia repair group, with 142.811 ± 52.102 minutes p-value (0.000). The hospital length of stay was shown to be shorter in laparoscopic hernia repair (1.58 ±1.27) compared to open hernia repair (2.05±5.33). The most common postoperative complication was scrotal swelling, commonly associated with laparoscopic (5.55%) compared to 2.11% in open hernia repair. Open repair showed a risk of scrotal hematoma with a percentage of 0.52% compared to 0% in the laparoscopic method with a p-value (0.033). Hernia recurrence was non-related with any specific group, although noted to be higher in the laparoscopic group (7.77%), while in the open group (3.4%) with a p-value (0.081). The study conducted showed no alarming percentages for recurrence in either technique, open or laparoscopic, yet the open approach had a better outcome when it comes to scrotal pain and swelling post-operatively, chronic groin pain, and readmission rate as compared to laparoscopic technique, despite having a longer hospital stay. Future larger studies should be conducted to provide equal population inclusivity.
Language	English
Publishing date	2023-10-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.46419
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Article ; Online: Biliary anatomy and pancreatic duct variations: A cross-sectional study.

Aljiffry, Murad / Abbas, Mohammad / Wazzan, Mohammad A M / Abduljabbar, Ahmed H / Aloufi, Safiyah / Aljahdli, Emad

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association

2020

Abstract: Background/aim: Biliary tree and pancreatic duct can appear in different variations whose proper understanding is obligatory for surgeons. Magnetic resonance cholangiopancreatography (MRCP) is considered a safe and accurate tool for evaluating biliary ... ...

Abstract	Background/aim: Biliary tree and pancreatic duct can appear in different variations whose proper understanding is obligatory for surgeons. Magnetic resonance cholangiopancreatography (MRCP) is considered a safe and accurate tool for evaluating biliary tree and pancreatic duct. Typical anatomy for right hepatic duct (RHD) and left hepatic duct (LHD) is reported as 57% and 63%, respectively. The most common (4-10%) pancreatic anomaly is divisum. In the present study, we evaluated and determined the prevalence of biliary tree and pancreatic duct variations among patients at a university hospital. Materials and methods: The MRCP records of 370 patients from 2015 to 2017 were obtained for cross-sectional study. Images were retrospectively reviewed for variations by two independent senior radiologists. Demographic data were obtained for all the patients. Huang et al. classification was used for RHD and LHD variations. The cystic duct was reported based on its course and insertion pattern. The pancreatic duct was observed for the presence of divisum, its course, and configuration. Results: Three hundred and twenty-five patients were included in the final study. Most commonly observed variant for RHD were A1 (34.2%) and A2 (32.2%). For LHD, B1 (71.4%) was the most common variant. Cystic duct insertion was commonly seen as right lateral insertion (27.7%). Pancreatic divisum was observed in 0.6% of cases. Nationality, origin, and gender-specific variations were obtained. Conclusion: Variations in biliary anatomy and pancreatic duct are very diverse and extend from the intrahepatic biliary system down to the pancreas. Performing a similar study on a larger population is mandatory to illustrate the range of variations present within the community.
Language	English
Publishing date	2020-05-26
Publishing country	India
Document type	Journal Article
ZDB-ID	2299174-8
ISSN	1998-4049 ; 1319-3767
ISSN (online)	1998-4049
ISSN	1319-3767
DOI	10.4103/sjg.SJG_573_19
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Article ; Online: Transient small bowel intussusception in an adult: case report with intraoperative video and literature review.

Aref, Hager / Nawawi, Abrar / Altaf, Abdulmalik / Aljiffry, Murad

BMC surgery

2015 Volume 15, Page(s) 36

Abstract: Background: The term intussusception refers to invagination of a segment of the gastrointestinal tract into the lumen of an adjacent segment. This is a rare entity and it is more prevalent in children and less common in adults. The diagnosis of ... ...

Abstract	Background: The term intussusception refers to invagination of a segment of the gastrointestinal tract into the lumen of an adjacent segment. This is a rare entity and it is more prevalent in children and less common in adults. The diagnosis of intussusception in adults is difficult as a result of the nonspecific signs and symptoms. As there are many common causes of acute abdomen, intussusception should be considered when more frequent etiologies have been ruled out. The laparoscopic approach offers both a diagnostic option and a therapeutic one for intussusception in adults. Case presentation: We report a forty-one year old male patient, who presented to our Emergency Department complaining of peri-umbilical pain associated with nausea and vomiting for 1 day. Diagnosed with transient small bowel intussusception without any obvious underlying pathology. This report is the first to present an intra-operative video showing the small bowel intussuscepting and reducing spontaneously. Furthermore, the authors present a review about this rare condition, including previously reported similar cases in literature. Conclusion: Transient intussusception is extremely rare and is a challenging condition. Imaging techniques, especially CT scan, are helpful in the diagnosis of intussusception. However, laparoscopy offers the advantage of distinguishing transient intussusception from persistent intussusception.
MeSH term(s)	Abdominal Pain/etiology ; Adult ; Humans ; Intestine, Small/surgery ; Intussusception/complications ; Intussusception/diagnosis ; Intussusception/surgery ; Laparoscopy ; Male ; Remission, Spontaneous ; Vomiting/etiology
Language	English
Publishing date	2015-04-03
Publishing country	England
Document type	Case Reports ; Journal Article ; Review ; Video-Audio Media
ZDB-ID	2050442-1
ISSN	1471-2482 ; 1471-2482
ISSN (online)	1471-2482
ISSN	1471-2482
DOI	10.1186/s12893-015-0020-6
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Article: A Large Stomach Ulcer Is Associated With Raised Mortality in a Cohort of Patients Who Underwent Open Repair of Perforated Peptic Ulcer: A Five-Year Follow-Up Study.

Aljiffry, Murad / Alshehrani, Esraa A / Saeed, Afnan / Albugmi, Fatemah / Alsulami, Israa / Alzahrani, Walaa / Al-Radi, Osman O / Alzahrani, Anas H

Cureus

2020 Volume 12, Issue 8, Page(s) e9790

Abstract: Introduction Perforated peptic ulcer disease (PPUD) is associated with a high postoperative mortality and morbidity rates especially within the first 90 days. The size and site of the ulcer may contribute to the prognosis of PPUD. In this study, we will ... ...

Abstract	Introduction Perforated peptic ulcer disease (PPUD) is associated with a high postoperative mortality and morbidity rates especially within the first 90 days. The size and site of the ulcer may contribute to the prognosis of PPUD. In this study, we will describe the association of size and site of PPUD with the overall mortality and in-hospital morbidities in a tertiary care university hospital. Methods A retrospective observational cohort study was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. A total of 50 patients who had PPUD and underwent open exploratory laparotomy with surgical treatment were analyzed. Patients were divided into two groups: a small ulcer group when the ulcer diameter was less than equal to 1 cm and a large ulcer group when it was more than 1 cm. For the subgroup analysis, patients were categorized according to site into small duodenum, large duodenum, small stomach, and large stomach PPUD. The primary outcome was overall mortality that was measured by survival analysis and Cox regression. Secondary outcomes were intensive care unit (ICU) admission, ICU and hospital length of stay, and in-hospital mortality, which were assessed by stepwise logistics and linear regression. Results Overall mortality at 10, 30, and 90 days was 14% (95% CI: 0.06-0.27), 24% (95% CI: 0.14-0.39), and 34% (95% CI: 0.23-0.49), respectively. Saudi patients had a 72% decreased risk of overall mortality compared to non-Saudi patients (P=0.03) over the follow-up period. Overall, patients who had stomach PPUD had a 2.23-fold increased risk of overall mortality over time compared to those who had duodenum PPUD (P=0.10). Large PPUD, >1 cm, had a 3.20-fold increased risk of overall mortality over time compared to small PPUD (P=0.04). Large stomach PPUD had a 4.22-fold increased risk of overall mortality over time compared to other ulcers (P=0.01). Conclusions Large stomach PPUD is associated with increased overall mortality and morbidity. These findings indicate that patients who have a large stomach PPUD might need careful perioperative and postoperative personalized surgical plans as these patients may eventually undergo complicated surgical procedures.
Language	English
Publishing date	2020-08-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.9790
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Article: Coexistence of Primary GEJ Adenocarcinoma and Pedunculated Gastric Gastrointestinal Stromal Tumor.

Alkaaki, Aroub / Abdulhadi, Basma / Aljiffry, Murad / Nassif, Mohammed / Al-Maghrabi, Haneen / Maghrabi, Ashraf A

Case reports in surgery

2018 Volume 2018, Page(s) 4378368

Abstract: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive system, although they account for only 0.1-3% of all gastrointestinal (GI) malignancies. They can arise anywhere along the GI tract with gastric predominance. ...

Abstract	Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive system, although they account for only 0.1-3% of all gastrointestinal (GI) malignancies. They can arise anywhere along the GI tract with gastric predominance. Concurrent occurrence of GIST and gastroesophageal junction (GEJ) neoplasm is rare. We report a 55-year-old gentleman presenting with a polyp at the GEJ and a synchronous, large, and pedunculated gastric mass at the greater curvature. Those were treated with a wedge resection of the gastric pedunculated mass with negative margins along with transgastric submucosal resection of the GEJ polyp. Pathological examination confirmed synchronous invasive GEJ adenocarcinoma and a high-grade gastric GIST.
Language	English
Publishing date	2018-06-11
Publishing country	United States
Document type	Case Reports
ZDB-ID	2657697-1
ISSN	2090-6919 ; 2090-6900
ISSN (online)	2090-6919
ISSN	2090-6900
DOI	10.1155/2018/4378368
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Article ; Online: Effect of Insulin Therapy using Hyper-insulinemic Normoglycemic Clamp on Inflammatory Response in Brain Dead Organ Donors.

Aljiffry, M / Hassanain, M / Schricker, T / Shaheen, M / Nouh, T / Lattermann, R / Salman, A / Wykes, L / Metrakos, P

Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association

2016 Volume 124, Issue 5, Page(s) 318–323

Abstract: Background: Brain death is a major stress that is associated with a massive inflammatory response and systemic hyperglycemia. Severe inflammation leads to increased graft immunogenicity and risk of graft dysfunction; while acute hyperglycemia aggravates ...

Abstract	Background: Brain death is a major stress that is associated with a massive inflammatory response and systemic hyperglycemia. Severe inflammation leads to increased graft immunogenicity and risk of graft dysfunction; while acute hyperglycemia aggravates the inflammatory response and increases the risk of morbidity and mortality. Insulin therapy not only controls hyperglycemia but also suppresses inflammation. The present study is to investigate the anti-inflammatory properties and the normoglycemia maintenance of high dose insulin on brain dead organ donors. Design: 15 brain dead organ donors were divided into 2 groups, insulin treated (n=6) and controls (n=9). Insulin was provided for a minimum of 6 h using the hyperinsulinemic normoglycemic clamp technique. The changes of serum cytokines, including IL-6, IL-10, IL-1β, IL-8, TNFα, TGFα and MCP-1, were measured by suspension bead array immunoassay and glucose by a glucose monitor. Results: Compared to controls, insulin treated donors had a significant lower blood glucose 4.8 (4-6.9) vs. 9 (5.6-11.7) mmol/L, p<0.01); the net decreases of pro-inflammatory cytokines, such as IL-6 and MCP-1, and the net increase of anti-inflammatory cytokine, such as IL-10, reached significant level in insulin treated donors compared with those in controls. Conclusion: High dose insulin therapy decreases the concentrations of inflammatory cytokines in brain dead donors and preserves normoglycemia. High dose of insulin may have anti-inflammatory effects in brain dead organ donors and therefore, improve the quality of donor organs and potentially improve outcomes.
MeSH term(s)	Adult ; Aged ; Brain Death/blood ; Cytokines/blood ; Cytokines/drug effects ; Female ; Humans ; Inflammation/blood ; Inflammation/drug therapy ; Insulin/administration & dosage ; Insulin/pharmacology ; Male ; Middle Aged ; Organ Transplantation/methods ; Tissue Donors
Chemical Substances	Cytokines ; Insulin
Language	English
Publishing date	2016-05
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1225416-2
ISSN	1439-3646 ; 0947-7349
ISSN (online)	1439-3646
ISSN	0947-7349
DOI	10.1055/s-0042-101240
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Article ; Online: Delayed hemobilia due to hepatic artery pseudo-aneurysm: a pitfall of laparoscopic cholecystectomy.

Alrajraji, Mawaddah / Nawawi, Abrar / Jamjoom, Reda / Qari, Yousef / Aljiffry, Murad

BMC surgery

2016 Volume 16, Issue 1, Page(s) 59

Abstract: Background: Hepatic artery pseudoaneurysm as a complication of laparoscopic cholecystectomy is considered a rare, potentially life threatening condition.: Case presentation: We report a case of late onset hemobilia presenting 8 months following ... ...

Abstract	Background: Hepatic artery pseudoaneurysm as a complication of laparoscopic cholecystectomy is considered a rare, potentially life threatening condition. Case presentation: We report a case of late onset hemobilia presenting 8 months following elective laparoscopic cholecystectomy with complex biliary and vascular injury. The patient was treated surgically with primary repair of the aneurysm and hepaticojujenostomy. Conclusion: A high index of suspicion should be raised when encountering a patient with massive upper GI bleeding and a previous history of hepatobiliary manipulation or surgery regardless of postoperative period.
MeSH term(s)	Adult ; Aneurysm, False/etiology ; Cholecystectomy, Laparoscopic/adverse effects ; Cholecystitis/surgery ; Female ; Gastrointestinal Hemorrhage/etiology ; Hemobilia/etiology ; Hepatic Artery ; Humans
Language	English
Publishing date	2016-08-22
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2050442-1
ISSN	1471-2482 ; 1471-2482
ISSN (online)	1471-2482
ISSN	1471-2482
DOI	10.1186/s12893-016-0175-9
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Article: Ruptured spontaneous splenic artery aneurysm: A case report and review of the literature.

Abdulrahman, Aisha / Shabkah, Alaa / Hassanain, Mazen / Aljiffry, Murad

International journal of surgery case reports

2014 Volume 5, Issue 10, Page(s) 754–757

Abstract: Introduction: Splenic artery aneurysm is a rare condition, however, potentially fatal. The importance of splenic artery aneurysm lies in the risk for rupture and life threatening hemorrhage.: Presentation of case: This is a case of a ruptured splenic ...

Abstract	Introduction: Splenic artery aneurysm is a rare condition, however, potentially fatal. The importance of splenic artery aneurysm lies in the risk for rupture and life threatening hemorrhage. Presentation of case: This is a case of a ruptured splenic artery aneurysm in a 58-year-old lady. She presented with hypovolemic shock and intra-peritoneal bleeding. Diagnosis was confirmed by CT angiography and she was managed by operative ligation of the aneurysm with splenectomy and distal pancreatectomy. Discussion: The literature pointed the presence of some risk factors correlating to the development of splenic artery aneurysm. In this article we discuss a rare case of spontaneous (idiopathic) splenic artery aneurysm and review the literature of this challenging surgical condition. Conclusion: Splenic artery aneurysm needs prompt diagnosis and management to achieve a favorable outcome, high index of suspicion is needed to make the diagnosis in the absence of known risk factors.
Language	English
Publishing date	2014-09-02
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2014.08.021
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Article ; Online: Portal vein embolization and its effect on tumour progression for colorectal cancer liver metastases.

Simoneau, E / Hassanain, M / Shaheen, M / Aljiffry, M / Molla, N / Chaudhury, P / Anil, S / Khashper, A / Valenti, D / Metrakos, P

The British journal of surgery

2015 Volume 102, Issue 10, Page(s) 1240–1249

Abstract: Background: The aim of this study was to evaluate the long-term outcomes of patients with colorectal cancer liver metastasis (CRCLM) exhibiting disease progression after portal vein embolization (PVE).: Methods: Patients with CRCLM requiring PVE ... ...

Abstract	Background: The aim of this study was to evaluate the long-term outcomes of patients with colorectal cancer liver metastasis (CRCLM) exhibiting disease progression after portal vein embolization (PVE). Methods: Patients with CRCLM requiring PVE before hepatectomy between 2003 and 2014 were included. Clinical variables, and liver and tumour volumes determined by three-dimensional CT volumetry were assessed before and after PVE. Overall and disease-free survival data were obtained. Univariable and multivariable logistic regression analyses were performed to identify predictors of tumour progression after PVE. Results: Of 141 patients who underwent PVE, 93 (66.0 per cent) had tumour progression and 17 (12.1 per cent) developed new contralateral lesions. Significantly fewer patients had resectable disease in the group with disease progression than among those with stable disease: 43 (46 per cent) of 93 versus 36 (75 per cent) of 48 respectively (P = 0.001). Median survival was similar in patients with and without tumour growth after PVE: 22.5 versus 26.0 months for patients with unresectable tumours (P = 0.706) and 46.2 versus 52.2 months for those with resectable disease (P = 0.953). However, disease-free survival for patients with tumour progression after PVE was shorter than that for patients with stable disease (6.0 versus 20.2 months; P = 0.045). Response to neoadjuvant chemotherapy was the only significant factor associated with tumour progression in multivariable analysis. Conclusion: Tumour progression after PVE did not affect overall survival, but patients with resected tumours who had tumour growth after embolization experienced earlier recurrence. A borderline response to neoadjuvant chemotherapy seemed to be associated with tumour progression after PVE.
MeSH term(s)	Antineoplastic Agents/administration & dosage ; Chemoembolization, Therapeutic/methods ; Colorectal Neoplasms/diagnostic imaging ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/therapy ; Disease Progression ; Female ; Humans ; Imaging, Three-Dimensional ; Infusions, Intravenous ; Liver Neoplasms/diagnosis ; Liver Neoplasms/secondary ; Liver Neoplasms/therapy ; Male ; Middle Aged ; Neoplasm Metastasis ; Portal Vein ; Preoperative Care/methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; Tumor Burden
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2015-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.9872
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Article ; Online: Acute Pancreatitis: A Complication of Intragastric Balloon.

Aljiffry, Murad / Habib, Razan / Kotbi, Eman / Ageel, Amro / Hassanain, Mazen / Dahlan, Yaser

Surgical laparoscopy, endoscopy & percutaneous techniques

2017 Volume 27, Issue 6, Page(s) 456–459

Abstract: Purpose: This study was carried out because intragastric balloon (IGB) is a widely used method to combat obesity, and acute pancreatitis complicating IGB is rare and yet to be understood.: Method: This study was a retrospective analysis of all ... ...

Abstract	Purpose: This study was carried out because intragastric balloon (IGB) is a widely used method to combat obesity, and acute pancreatitis complicating IGB is rare and yet to be understood. Method: This study was a retrospective analysis of all patients with a history of IGB insertion, who developed acute pancreatitis before balloon removal. Results: A total of 4 cases were found, with a mean age of 27±2.9 years. The mean duration of IGB insertion was 2.25±1.25 months, with an average body mass index of 37.7±3.4 kg/m. Abdominal computed tomography visualized signs of pancreatitis with the balloon compressing the pancreatic body. Pancreatitis resolved after endoscopic balloon extraction, with an average aspiration of 607.5±64.5 mL of the fluid used to fill the balloon. Conclusion: Our study demonstrates that acute pancreatitis can complicate IGB and recommends the need to measure amylase and lipase in patients who have a history of IGB insertion and present with a picture suggestive of pancreatitis.
MeSH term(s)	Adult ; Device Removal ; Endoscopy, Gastrointestinal ; Female ; Gastric Balloon/adverse effects ; Humans ; Male ; Obesity/surgery ; Pancreatitis/diagnostic imaging ; Pancreatitis/etiology ; Pancreatitis/surgery ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult
Language	English
Publishing date	2017-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0000000000000477
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