Surgery, Gastroenterology and Oncology

Read article Introduction: Blunt or penetrating pancreatic trauma represents only 0.2-2% of all trauma cases and approximately 3-12% of all abdominal injuries. While treatment protocol debates of other intraabdominal and thoracic organ injuries seem to reach comforting conclusions, satisfying evidencebased recommendations regarding the pancreas have not been released yet. However, high grade trauma of the pancreas can lead to substantial morbidity and mortality. The question is, when and how to treat it conservatively or operatively.

Objectives/Methods: This study is a revi....[more]

Read article Portal vein thrombosis (PVT) increases the surgical complexity of living donor liver transplantation (LDLT) and pre-transplant complete PVT is associated with decreased 1-year patient survival. Increased experience in the field of liver transplantation (LT) and refinements of the surgical techniques have led to successful outcomes even in recipients with complete PVT. Such techniques include thrombectomy of the native portal vein, extensive thromboendovenectomy up to the splenomesenteric confluence, venous conduit interposition and portocaval hemitransposition. In this report, we des....[more]

Read article Background: Liver resection for colorectal liver metastasis (CRLM) represents a valid therapeutic option. It can offer a chance of good long-term survival, with a 5 year survival of 25- 40%. Recent studies have shown that achieving a minimum of 1 cm surgical margin is not essential for long-term survival, and a microscopic free liver resection margin can be sufficient.
The aim of this study is to evaluate the impact of the resection margin on recurrence, disease free survival and the overall survival.

Materials and Method: All the primary liver resections ....[more]

Read article Background: Liver resection (LR) is the standard treatment for most focal liver lesions. Intraoperative ultrasound (IOUS) improves their diagnosis and guides the liver resection. The present paper analyses our experience in IOUS guided LR, reviewing the indications, surgical techniques, and the short-term results.

Material and Method: 198 LRs guided by IOUS in 186 patients operated in our center between January 2013 and December 2017 were included in a combined prospective and retrospective study. The median age of the patients was 60 years (mean 57, range 16....[more]

Read article Previous reports show that incidental gallbladder cancer (iGbC) occurs in less than 2% of patients after routine cholecystectomy. The aim of this retrospective study was to analyse the incidence and preoperative risk factors associated with iGbC at our department.

Patients and Methods: Between January 2006 and October 2016, a total of 480 cholecystectomies were performed, and we divided the cohort into two groups: iGbC Group (iGbC G) and non-Gb cancer group (nGbC G). Univariate and multivariate analyses assessing preoperative clinical and laboratory characteristics ....[more]

Read article Background: Mesopancreas is the most common site for R1 resection and local recurrence. This study was designed to compare standard pancreatoduodenectomy (PD) versus posterior approach pancreatoduodenectomy PAPD in treating pancreatic head cancer.

Methods: All patients underwent PD for pancreatic head cancers from January 2006 to December 2015 were evaluated. Patients were divided into two groups. Group A patients underwent standard PD and group B underwent PAPD. The primary outcome was postoperative survival.

Results: The study included 210....[more]

Read article Background: Gastric subepithelial tumors (SETs) are often encountered in endoscopy without any special symptoms.The effectiveness of current diagnostic tissue sampling techniques for gastric SETs is limited. Better tissue acquisition methods are required to improve the diagnostic yield in patients with gastric SETs.The purpose of this study is to assess the safety and diagnostic effectiveness of an endoscopic incisional target biopsy technique for gastric SETs.

Methods: This study was intended for patients with gastric SETs with failed tissue diagnosis by con....[more]

Read article Background: Recently, there has been a growing enthusiasm in developing new techniques of intracorporeal anastomosis following laparoscopic colectomy, which are more challenging than extracorporeal techniques. However, the evidence is still lacking regarding the outcomes comparison of both procedures.

Methods: We designed a retrospective study comparing intracorporeal and extracorporeal anastomosis following laparoscopic right colectomy. A total of 115 consecutive patients operated for right colon disease were identified, from September 1st 2014 to May 31st 2....[more]

Read article Focal nodular hyperplasia (FNH) is the second most common type of benign liver tumour, and it is more frequently encountered in young women and the right hemi-liver. Most patients are asymptomatic, and there is no malignant potential. Thus, the current guidelines do not recommend any treatment for uncomplicated FNH, and surgery is indicated only for some atypical patients (with complications or uncertain diagnosis).

Pedunculated forms are atypical, rare features of FNH and appear to be more frequently associated with complications. We hereby report the case of a 40-year-old ....[more]