Prevalence of Pancreaticobiliary Maljunction (PBM) Among Sudanese Patients with Obstructive Jaundice in Ibnsina Specialized Hospital

Background: pancreaticobiliary maljunction is a congenital malformation in which the pancreatic and bile ducts join outside the duodenal wall. The common channel is long that leads to continuous reciprocal reflux between pancreatic juice and bile, resulting in various pathologic conditions in the biliary tract and pancreas. Methods and patients: This is a hospital based descriptive cross-sectional study, which was conducted in Ibn Sina Specialized Hospital over a period of one year (August 2018 – August 2019). The study included 62 patients. Data was collected using a constructed structure pretest questionnaire. Results: the mean age of the patients was 50.5, with male to female ratio 1:2.1. The majority of patients presented with the symptoms of bile obstruction .MRCP was done for all patients ; showed that CBD stones was the most common diagnosis in 82.3 %(n=51), followed by pancreatic carcinoma 6.5%(n=4). PBM found in 35.5 %( n= 22); the majority were type B 24.2% (n=15). In patients with CBD stones 82.3 %(n=51), PBM type B was the most common anomaly found 23.5% (n=12), the serum direct bilirubin was <5 mg/dl in 78%(n=40),and ALP more than 300 U/L in the majority of them. Conclusion : The prevalence of PBM is 35.5% , commonly found in female. The most common type of PBM is - type B, commonly found in patients with obstructive jaundice due to CBD stones

Outcome of Palliative Surgery in Advanced Pancreatic Cancer in Sudanese Patients in Ibn Sina Specialized Hospital

Introduction: Pancreatic cancer is the 4thleading cause of death and due to late presentation, the curative procedures are more challenging and difficult. Pancreatic cancer is not uncommon in Sudanese patients and usually presents late. The aim of this study was to assess the outcome of palliative surgery in advanced pancreatic cancer and to reflect our local experience. Methodology: It was a prospective cross-sectional hospital-based study.  It included 92 patients with advanced pancreatic cancer in Ibn Sina Specialized Hospital. Data were collected and variables; age, gender, origin and clinical features were measured. Patients were classified based on type of surgery (single, double or triplebypass). Data collected and analyzed by using statistical package for social sciences (SPSS) computer program version 20.Qualitative data were analyzed by using descriptive statistic t test and pearson chi_square. The P value was considered significant if <0.05. Results:The mean age of the study was 65.4, (+/_13SD)male to female ratio was 1.8:1. The majority of the patients (36%) were from northern state; namely Shwaiga, Mahas, Bederia and Gaalian and 22% from Western state namely Baggara, Jamoaia and Foor. Nearly two-third of the patients had double bypass, and the remaining were equally single and triple bypass. The main presenting symptoms were jaundice, dyspepsia and vomiting and it is significantly common among alcohol consumers. Dyspepsia was statistically early symptoms and serum aspartate transaminase (AST) and alkaline phosphatase (ALP) were statistically high. There was less than 30 % of those who survived more than one year. There was no statistically significant difference between type of bypass and the outcome. Conclusion: The outcome of those patients was not affected by modality of bypass. Dyspepsia was the earliest complain and high serum aspartate transaminase (AST) and alkaline phosphatase (ALP) could be important prognostic factors. pancreatic cancer is common in certain populations