Ghattas Khoury - Academia.edu (original) (raw)

Papers by Ghattas Khoury

Surgical Endoscopy and Other Interventional Techniques, 1996

We have previously reported on the laparoscopic treatment of hydatid cysts of the liver. We now r... more We have previously reported on the laparoscopic treatment of hydatid cysts of the liver. We now report the successful treatment of 18 cysts in 12 patients with a median follow-up of 12 months. The standard treatment in the open technique was performed laparoscopically. The main concern was to prevent spillage of the hydatid fluid, for which the puncture and evacuation of the cyst is carried under scolicidal agents cover using 1% cetrimide, thus decreasing the chances of recurrence. In this group of patients we had one biliary leak that ceased spontaneously and one recurrence of hydatid cyst but not in the same lobe. We conclude that laparoscopic evacuation of hydatid cysts is a successful operation comparable to the open technique, with the added advantages of the laparoscopic approach.

PubMed, Nov 7, 1999

Background: Laparoscopic colorectal surgery has many advantages to offer. However, it is a comple... more Background: Laparoscopic colorectal surgery has many advantages to offer. However, it is a complex procedure, and demands advanced technical skills and instrumentation. In addition, its safety when applied to malignant disease is debatable. In this article, we present the early experience and short term results of laparoscopic colorectal resections performed at the American University of Beirut Medical Center. Patients and methods: Between March 1997 and August 1998, 14 patients with various colorectal lesions underwent attempt at laparoscopic colorectal resection, at the American University of Beirut Medical Center. Seven patients were males (50%) and 7 were females (50%); their mean age was 59 yrs (range 40-73 yrs). Ten patients (72%) had malignant disease and 4 patients (28%) had benign disease. Results: The operation was completed in 13 out of 14 patients (93%). The overall mean operative time was 176 min (range 135-270 min). The operation was taking less time as surgeons gained experience. The average hospital stay was 7.6 days (range 4-11 days). The last four patients, however, stayed less than six days in the hospital. There were no mortalities. There were three complications (21%), two patients had wound infection, and one patient had a prolonged ileus. All were managed conservatively. Ten patients had malignant disease. In these patients, the operative margins were clear of disease. The average number of lymph nodes retrieved was 10.4 (range 3-19). These patients were followed up for an average period of 7.4 months (range 1-16 months). There was one recurrence. There was no port site metastasis in any patient. Conclusion: Laparoscopic colorectal surgery is feasible and safe. The preliminary results are encouraging. Its application in malignant disease still awaits the results of prospective studies.

World Journal of Colorectal surgery, 2014

Canadian Journal Of Anesthesia/journal Canadien D'anesthésie, Apr 1, 1993

Ambulatory Surgery, Mar 1, 1993

PubMed, Jan 7, 1999

Background and objectives: The incidence of postoperative vomiting in patients undergoing laparos... more Background and objectives: The incidence of postoperative vomiting in patients undergoing laparoscopic cholecystectomy is compared in females versus males. The report also compares the prophylactic action of ondansetron versus metoclopramide. Methods: A total of 85 American Society of Anesthesiologists (ASA) I and II patients were enrolled in the study. Patients were divided into two groups according to sex: Group I 53 females, and Group II 32 males. After anaesthetic induction, subjects received intravenously either 4 mg ondansetron or 10 mg metoclopramide. Results: The incidence of vomiting as well as the frequency of emetic episodes over 24 hours were analyzed in each group using X2 analysis. Data analysis revealed a significantly higher incidence (P < 0.05) of postoperative emesis in females 10:53 (18.9%) as compared to males 0:32 (0%). In the male group, no patient vomited postoperatively, whether prophylactic ondansetron or metoclopramide was used. While the incidence of emesis in the female group was lower (P < 0.05) in the ondansetron group (17.6%) than the metoclopramide group (29.6%). Conclusion: These results may indicate prophylactic antiemetic therapy in female patients undergoing laparoscopic cholecystectomy; ondansetron appears to be superior to metoclopramide.

Progress in Transplantation, Sep 1, 2015

American Journal of Roentgenology, Feb 1, 2006

The Learning Organization, Jul 1, 2006

PurposeTo track changes in management paradigms from the bureaucratic to the post‐bureaucratic to... more PurposeTo track changes in management paradigms from the bureaucratic to the post‐bureaucratic to the learning organization model, highlighting core differentiating features of each paradigm as well as necessary ingredients for successful evolution.Design/methodology/approachThe article takes the form of a literature review and critical analysis.FindingsThe complexity of the learning organization necessitates gradual evolution. The successful integration of the characteristics of post‐bureaucratic firms – empowerment, teamwork, trust, communication, commitment, and flexibility – coupled with an emergent systems perspective can provide improved understanding of how the learning organization disciplines may actually materialize.Originality/valueLinking two traditionally encapsulated areas of research namely post‐bureaucratic organizations and learning organizations, highlighting an interesting roadmap for successful convergence of post‐bureaucratic organizations towards learning organizations.

Digestive Diseases and Sciences, Dec 1, 2003

European Journal of Vascular Surgery, Dec 1, 1990

Over a 13 year period extending between April 1975 and June 1988, 510 neck injuries were treated ... more Over a 13 year period extending between April 1975 and June 1988, 510 neck injuries were treated at the American University of Beirut Medical Center; the carotid vessels were involved in 48 patients, resulting in 53 carotid injuries. The mean age of the patients was 25.3 years and shrapnel injuries were the commonest (45.8%), followed by bullet wounds (33%). Thirty-nine patients had a laceration and five had complete disruption of the carotid vessels and only three presented in coma. Shock was present in 14 patients, of whom five had a neurological deficit. In six the injured vessels were ligated, three of them were external carotid arteries. Nine patients were not initially operated on. Six of them had a chronic arterio-venous fistula and three were in coma. The remainder underwent surgical repair. Nine patients died, giving an overall mortality rate of 18.8%. Four of these died because of multisystem failure, thus giving a 10.4% mortality rate for the isolated carotid injury. There was definite improvement in the repaired group, but the haemodynamic status seemed to significantly affect the mortality rate (P less than 0.01). Follow-up of surviving patients has revealed five with persistent neurological deficits in the repaired group (33 patients), and four patients with a chronic arterio-venous fistula. Two patients had a false aneurysm. Carotid artery injury seems to have a good prognosis if repaired promptly within 3 h.

Surgical Endoscopy and Other Interventional Techniques, Mar 1, 2000

Surgical Endoscopy and Other Interventional Techniques, Sep 1, 1997

PubMed, May 1, 2000

Laparoscopic instrumentation of the common bile duct (CBD) via the transcystic route or through d... more Laparoscopic instrumentation of the common bile duct (CBD) via the transcystic route or through direct choledochotomy seems to be safe, but in rare cases, complications such as pancreatitis, bile duct damage, and hemorrhage from cystic artery may occur. We report an unusual complication with this approach. A 62-year-old man with gallbladder stones presented with obstructive jaundice, mild pancreatitis, and a dilated CBD. He underwent laparoscopic cholecystectomy with an intraoperative cholangiogram through the cystic duct. A small stone seen in the CBD was removed using a 6-Fr vascular Fogarty catheter. Two days later, he became jaundiced again with a rising bilirubin. An endoscopic retrograde cholangiogram showed a 1.5-cm round filling defect floating in a dilated CBD. A sphincterotomy was performed, and a balloon catheter was inflated proximally and pulled down. To our surprise, the filling defect was a crystal clear object, which we finally realized was a fully inflated Fogarty catheter balloon. The balloon spontaneously deflated while being caught with a basket. Surgeons should be aware of this possible complication, and every effort should be made to verify that the balloon still is in place after removal of the embolectomy catheter. Whether vascular embolectomy catheter balloons are appropriate for stone removal or more rigid balloons should be used needs further evaluation.

$Research paper thumbnail of Mesh-wrapping for the treatment of fractured liver—A case report$

International Journal of Surgery Case Reports, 2016

European Journal of Vascular Surgery, Jul 1, 1993

Cardiovascular Surgery, Jun 1, 1996

European Journal of Vascular Surgery, Oct 1, 1988

Over a 10-year-period extending from January 1976 to September 1986, 800 peripheral vascular inju... more Over a 10-year-period extending from January 1976 to September 1986, 800 peripheral vascular injuries were surgically treated at the American University of Beirut Medical Centre. Of these, 150 were operated on because of injury to the femoral vessels. Bullets were the commonest wounding agents (60% of cases). Thirty-seven patients had a femoral artery injury, 27 a femoral vein injury and 86 combined femoral artery and vein damage. Twenty-three per cent of the patients had an associated fracture of the femur. Patients with fractures had an 11% amputation rate compared with 1% for those without fractures. Our data reveals the importance of venous reconstruction in the presence of an arterial injury instead of its ligation (P less than 0.05), particularly when there is an associated fracture of the femur. Thirty-seven per cent of patients were in shock on admission (systolic BP 90 mmHg). The amputation rate in these patients was 6.8% in contrast to 1% in the haemodynamically stable group (P less than 0.05). The overall amputation rate was 3.3%. Complications occurred in 36.6% of patients and the mortality was 4.0%.

World Journal of Surgery, Nov 1, 1992