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Item type:Publication, Expansion of laparoscopic cholecystectomy in a resource limited setting, Mongolia: a 9-year cross-sectional retrospective reviewBACKGROUND: The benefits of laparoscopic cholecystectomy have been largely unavailable to most people in developing countries. Mongolia has an extremely high incidence of gallbladder disease. In 2005, only 2% of cholecystectomies were being done laparoscopically. Open cholecystectomies were associated with high rates of wound infections, complications, and increased recovery time. Because of the unacceptable complications associated with open cholecystectomies, and nearly 50% of the nomadic population needing faster post-operative recovery times, a national project for the development of laparoscopic surgery was organised. Multi-institutional collaboration between the Mongolia Health Sciences University, the Dr W C Swanson Family Foundation (SFF), the University of Utah, Intermountain Healthcare, and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) led to the promulgation of a formalised countrywide laparoscopic training programme during the past 9 years. This is a retrospective review of the transition from open to laparoscopic cholecystectomy throughout Mongolia. METHODS: Demographic patient data, diagnosis, and operation preformed-laparoscopic versus open cholecystectomy, between January, 2005, and September, 2013, were collected and trends were analysed from seven regional diagnostic referral and treatment centres, and two tertiary academic medical centres from six of the 21 provinces (Aimags) throughout Mongolia. Data were analysed by individual training centre, by year, and then compared between rural and urban centres. FINDINGS: Nearly 16 000 cholecystectomies were analysed and compared (4417 [28·2%] men; 11 244 [71·8%] women). Men and women underwent laparoscopic cholecystectomy with the same frequency (41·2% men, 43·2% women) and had similar age (men, mean 52·2 years [SD 14·8]; women, mean 49·4 years [SD 15·7]). By 2013, 62% of gallbladders were removed laparoscopically countrywide as opposed to only 2% in 2005. More than 315 Mongolian practitioners have received laparoscopic training in 19 of 21 Aimags. On average 60% of cholecystectomies are done laparoscopically in urban surgical centres, up from 2%, versus 55% in rural surgical centres, up from 0%, in 2005. Laparoscopic cholecystectomy surpassed open cholecystectomy as the primary method for gallbladder removal countrywide in 2011. INTERPRETATION: By 2013, 62% of cholecystectomies countrywide were done laparoscopically, a great increase from 9 years ago. Despite being a resource limited country, the expansion of laparoscopic cholecystectomy has transformed the care of biliary tract disease in Mongolia. FUNDING: The University of Utah Center for Global Surgery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Status of Human Echinococcosis in Western Mongolia(Mongolian National University of Medical Sciences, 2019-03-31); ; ; Sumiya, GanzorigObjective: The purpose of this study was to identify cases of human echinococcosis in the Bayan-Ulgii, Khovd provinces, to determine their WHO classification by ultrasound and to identify the haplotype in surgically cysts removed. Methods: A total of 1063 people participated in ultrasound screening. Patients who had a positive echinococcosis by ultrasound underwent serologic testing for detection of antibodies for echinococcosis. Results: Ninety people were positive for the liver cystic lesions by ultrasound screening of which 12 cases were newly diagnosed cystic echinococcosis. Four were cystic echinococcosis stages 1-2, five were stage 3, while three were cystic echinococcosis stage 4. Thirty-three patients with previously known echinococcosis stage 2 and alveolar echinococcosis stage 4 were also examined. Out of 29 cystic echinococcosis cases, 24 underwent treatment. Of 24 who underwent treatment, only one was cured. The haplotypes E. canadensis G6/7 and E. granulossus s.s. G1 were confirmed by evaluating the cytochrome c oxidase subunit I gene of mitochondrial DNA in two patients in Bayan-Ulgii. Conclusion: Ninety people were positive for cystic echinococcosis in western Mongolia of which 12 cases were newly diagnosed cases. Of the 12 new cystic echinococcosis cases, 4 were stages 1-2, 5 were stage 3 and 3 were stage 4 by WHO classification. The haplotype in Bayan-Ulgii population were E. canadensis and s.s. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ilioinguinal and Iliohypogastric Nerve Blocks in Children(Mongolian National University of Medical Sciences, 2017-02-25); ; Objectives: To examine ilioinguinal and iliohypogastric (ILIH) nerve block techniques among children. Methods: A total of 120 children, aged 1-16 years, were included in this prospective, randomized, single-blinded study. Children received an ILIH nerve block using the conventional fascial click of double “pop” technique on four different points: (Group I, n=30) ILIH block at the junction of the lateral one-fourth, the medial three-fourth in the line from the anterior superior iliac spine (ASIS) to the umbilicus; (Group II, n=28) approximately 2.5 mm medial to the ASIS; (Group III, n=30) 10 mm medial-superior to the ASIS; and (Group IV, n=30) 10mm medial-inferior to the ASIS. Intraoperative hemodynamic changes, postoperative pain intensity, time of first analgesic requirement, and correlation between BMI and groups were examined. Results: The average pain score 2 hours after operation was lowest in group I (1.04±1.23 [Cl 95%, 0-5.3]) and highest in group IV (2.88±2.47 [Cl 95%, 0-9]), a difference of statistically significance (p=0.0027). In group I only, the pain intensity had a weak, positive correlation with BMI (r=0.49, p=0.006). Conclusion: Group I used the best ILIH block technique. - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, Schwartz's Principles of Surgery(Mongolian National University of Medical Sciences, 2016-06-25); ; Lamid-Ochir, Bayarbaatar - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Early Results of High Tibial Osteotomy for Osteoarthritis in Mongolia(Mongolian National University of Medical Sciences, 2019-03-31); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Inferior vena cava stenosis-induced sinusoidal obstructive syndrome after living donor liver transplantation(The Korean Association of Hepato-Biliary-Pancreatic Surgery, 2016-08); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Монгол улсад тохиолдож буй ходоодны өмөнгийн оношилгоо, эмчилгээний асуудалд(2019-11-18); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Cost and outcomes of open versus laparoscopic cholecystectomy in Mongolia(Elsevier BV, 2018-09); Scopus© Citations 21 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Contributions of academic institutions in high income countries to anesthesia and surgical care in low- and middle-income countries: are they providing what is really needed?(2019-03); ; Lonnee, HermanScopus© Citations 6