Surgery, Gastroenterology and Oncology

Read article In patients with colorectal liver metastases (CLMs), liver resection still represents the only potentially curative therapy. However, during the last decade, it was observed that managing the patients with CLMs in a multidisciplinary teams (MDT) will improve survival rates.
Although these MDTs represent a prerequisite condition to improve the prognosis of these patients, the presence of a specialized liver surgeon in such structures allows a better allocation of the liver resection in patients with CLMs. Recent evidences revealed that liver surgeons recommended hepatectomy to a....[more]

Read article Even though lymph node status is one of the most important predictors of survival for patients undergoing curative-intent surgery for peri-hilar cholangiocarcinoma (PHCC), the optimal lymph node staging system for PHCC has not been identified.
Recently, the newly published 8th edition of the American Joint Committee on Cancer (AJCC) staging system reformed the criteria used to stage the lymph node status of PHCC patients but this change did not demonstrate to significantly improve the prognostic stratification of patients with PHCC. Among the several clinical tools that have be....[more]

Read article Introduction: Acute respiratory distress syndrome (ARDS) can cause severe morbidity and mortality after a pancreaticoduodenectomy (PD). However, very few studies have evaluated the risk factors for ARDS among patients undergoing abdominal surgery, with even fewer studies being performed for patients undergoing PD specifically.

Methods: We performed a retrospective chart analysis of 200 patients undergoing PD between February 2009 and April 2014 in our Department and investigated the risk factors for ARDS by analysing preoperative chest CT scan images and other....[more]

Read article Objective: Liver transplant recipients often develop metabolic syndrome (MetS) and de-novo non-alcoholic fatty liver disease (NAFLD). Our aim was to evaluate the cardiovascular risk in these patients using CXCL10,a serum biomarker whose expression levels have been associated with inflammatory diseases.

Methods: We assessed 60 liver transplant recipients for clinical and biological features. The cardiovascular risk was assessed using the Framingham risk score.

Results: HCV cirrhosis was the main indication for liver transplantation (69% of patien....[more]

Read article Background & aims: Prothrombin induced by vitamin K absence-II (PIVKA II) is a diagnostic marker and a major prognostic factor for hepatocellular carcinoma (HCC) with limited experience in European patients.
The aim of this study was to investigate the clinical utility of simultaneous measurement of alphafetoprotein (AFP) and PIVKA II for hepatocellular carcinoma (HCC) diagnosis.

Methods: In a Romanian cohort, we performed a case-control study to compare the performances of AFP and PIVKA-II serum levels for HCC diagnosis. To determine the diagnostic valu....[more]

Read article Background: Intrahepatic cholangiocarcinoma (ICC) is a rare malignant tumor arising from the epithelial cells of the intrahepatic bile ducts.
The aim of the present paper is to report a rare case of centrally located ICC involving the hepatocaval confluence and generating a tumor thrombus in the biliary duct of segment 4 expanding into the left hepatic duct and main common duct, mimicking a type IIIB Klatskin tumor.

Case presentation: A 66-year old female presented for epigastric abdominal pain and weight loss, with cytolysis (ALAT= 323 U l; normal ASAT),....[more]

Read article Although laparoscopic cholecystectomy is a well standardized technique, subtotal cholecystectomy is still a valid option in those cases in which a complete cholecystectomy is not feasible due to the anatomic conditions given by the underlying inflammatory status or when the absence of the Critical view of Safety (CVS) make unsafe to go on a complete operation.

Various techniques are described to perform a subtotal cholecystectomy, both open and laparoscopic.