Surgery, Gastroenterology and Oncology

Read article Backgrounds: Several anastomoses have been described for the reconstruction of the pancreatic stump after pancreaticoduodenectomy. No technique showed a superiority over the others in terms of post-operative pancreatic fistula formation (POPF) in open neither during a minimally invasive approach.

Methods: We compared the surgical outcomes of fourteen patients classified as high-risk for POPF who underwent a Blumgart anastomosis (BA) with that of patients who underwent a Cattell-Warren (CW). A 1:1 case-matched analysis was performed according to the variables of ....[more]

Read article Background: In the view of need for early identification of cases of Acute Pancreatitis [AP] who may end up dying in spite of rigorous treatment measures, many scores have been proposed claiming to be superior in doing so. This study compares 5 newer scores which are possible to be assessed in first few hours of admission with mortality as outcome.

Methods: It's a retrospective study of 200 consecutive cases of first episodes of AP in a tertiary care centre in India. Scores were compared at their optimal cut off values by sensitivity, specificity, Positive and N....[more]

Read article Introduction: Laparoscopic cholecystectomy (LC) has replaced open technique as the main surgical intervention in the treatment of gall bladder stones. There are different clinical and radiological predictors that are indicators for technically difficult LC.

Aim of the work: The aim of this study was to identify the clinical and radiological variables associated with difficult LC.

Methods: During the period from March 2018 to March 2021, 452 adult patients who presented with symptomatic gall bladder stones underwent LC. Different clinical and rad....[more]

Read article Background: Circulating cryoglobulins are detected in 40-60% of patients with HCV chronic infection, and cryoglobulinemic vasculitis is observed in 15% of cases.

Methods: We included 24 patients with HCV-related mixed cryoglobulinemia (MC) and 8 patients with asymptomatic HCV cryoglobulinemia, between 2016-2019. All patients received DAA therapy: 22 patients with ombitasvir paritaprevir ritonavir and dasabuvirand 10 patients with ledipasvir sofosbuvir. The primary endpoint was complete clinical remission of vasculitis at week 24.

Results: All 5 pa....[more]

Read article Objective: This study was designed to determine the relationship between metabolic syndrome as a risk factor for colorectal cancer.

Background: Overweight and obesity are leading risks for global deaths. Although the increase in obesity over the last 35 years has been most dramatic in the US and western industrialized countries, similar trends have also been seen in urban areas of many developing countries. There are multiple common health consequences of an elevated body mass index, including risk for several metabolic disorders, some cancers and ultimately i....[more]

Read article Background: A raised pre-treatment carcinoembryonic antigen (CEA) level is frequently observed in colorectal cancer patients with metastatic disease and is thought to be a reflection of disease burden. Additionally, there is a growing body of evidence highlighting the influence of a pro-inflammatory host-response on colorectal cancer progression. Proinflammatory cytokines IL-1 , IL-6, IL-8 and TNF have been implicated in this relationship through experimental and clinical studies. We set out to evaluate whether combining circulating inflammatory markers, such as these, with CE....[more]

Read article Background: Clips are commonly used to divide vessels in laparoscopic surgery. However, branches of the superior mesenteric vein (SMV), including the superior right colic vein (SRCV), are narrow, and the clips are too large to be used for these veins. During surgery, there is concern about the risk of bleeding due to vascular injury, as well as when detaching the clips after the procedure. Patients and

Methods: From January 2014 to December 2016, six patients with right side transverse colon cancer underwent clipless laparoscopic surgery were enrolled in this st....[more]

Read article A cecal phlegmon can be a difficult situation for a surgeon, since the treatment strategy must be decided with uncertainty of the phlegmon's origin: benign or malignant.
The most common causes are cecal diverticulitis, acute appendicitis and cecal carcinoma. More rarely, it can be caused by a appendicular diverticulitis (1). In this case, we present a case of a cecal diverticulum, which is a rare but benign medical condition, in a 52-year-old man who presented to the emergency department with a 3-day constant abdominal pain in the right lower quadrant with rebound and with an inc....[more]

Read article Bile duct injuries represent a rare but potentially serious complication after laparoscopic cholecystectomy, that often need multidisciplinary therapeutic approaches. Additionally, post cholecystectomy clip migration into the biliary tree has been described, mainly because of local inflammatory processes.
We present a case of a 65-year-old male with a bile duct injury and stricture after laparoscopic cholecystectomy treated endoscopically with sphincterotomy and stent positioning; initially with a plastic 10Fr stent and later with a totally covered metal stent.
At the rem....[more]

Read article Obesity and its surgical treatment have been increasing in the last decade. Roux-en-Y gastric bypass (RYGB) is one of the most common procedures performed, resulting in an excluded stomach that can be the home of pre- and postoperative pathology.
We present a case report of a 52 years-old man with melena and refractory anemia 2 years after RYGB. Although a possible etiology was found through esophagogastroduodenoscopy, the persistence of anemia determined the search for other causes. Additional abdominal CT revealed a tumoral mass in the excluded stomach with subsequent biopsy ....[more]