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Odabasi M, Yesil A, Ozkara S, Paker N, Ozkan S, Eris C, Yildiz MK, Abuoglu HH, Gunay E, Tekeşin K. Role of human neutrophil gelatinase associated lipocalin (NGAL) and Matrix Metalloproteinase-9 (MMP-9) overexpression in neoplastic colon polyps. Int J Clin Exp Med 2014; 7:2804-2811. [PMID: 25356142 PMCID: PMC4211792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 08/16/2014] [Indexed: 06/04/2023]
Abstract
To explore the role of Human neutrophil gelatinase associated lipocalin (NGAL) and Matrix Metalloproteinase-9 (MMP-9) overexpression in neoplastic polyps and might used as a marker to separate those from non-noeplastic polyps. The study was performed on total 65 cases, 40% (n = 26) of them females and 60% (n = 39) of them males, in Haydarpasa Numune Education and Research Hospital between March 2012 and June 2012. The assessment of immunostained sections was performed by a random principle by one experinced pathologists to the clinico-pathological data. NGAL expression was based on the presence of cytoplasmic and membranous staining. The NGAL intensities of the cases show highly statistically significantly difference according to the pathological results (p < 0.01). The NGAL prevalences of the cases show highly statistically significantly difference according to the pathological results (p < 0.01). The NGAL ID scores of the cases show highly statistically significantly difference according to the pathological results (p < 0.01). We could hypothesize that NGAL and MMP-9 overexpression in neoplastic polyps might be used as a marker to separate those from non-noeplastic polyps. However, in this study, we determined that NGAL overexpression could not distinguish dysplasia from adenocancer. Finally, we suggest NGAL and MMP-9 as an immunohistochemical marker for colonic dysplasia. To determine dysplasia in early steps of colorectal adenoma-carcinoma sequence, it could help to determine new targets in preventive cancer therapy for colorectal cancer. We suggest development of standards for study method, introduction to routine practice by investigating in future studies including many patients.
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Affiliation(s)
- Mehmet Odabasi
- Department of Surgery, Haydarpasa Numune Education and Research HospitalIstanbul, Turkey
| | - Atakan Yesil
- Department of Gastroenterology, Haydarpasa Numune Education and Research HospitalIstanbul, Turkey
| | - Selvinaz Ozkara
- Department of Pathology, Haydarpasa Numune Education and Research HospitalIstanbul, Turkey
| | - Nurcan Paker
- Department of Biochemistry, Duzen LaboratoryIstanbul, Turkey
| | - Sevil Ozkan
- Department of Internal Medicine, Haydarpasa Numune Education and Research HospitalIstanbul, Turkey
| | - Cengiz Eris
- Department of Surgery, Haydarpasa Numune Education and Research HospitalIstanbul, Turkey
| | - Mehmet Kamil Yildiz
- Department of Surgery, Haydarpasa Numune Education and Research HospitalIstanbul, Turkey
| | - Hacı Hasan Abuoglu
- Department of Surgery, Haydarpasa Numune Education and Research HospitalIstanbul, Turkey
| | - Emre Gunay
- Department of Surgery, Haydarpasa Numune Education and Research HospitalIstanbul, Turkey
| | - Kemal Tekeşin
- Department of Surgery, Haydarpasa Numune Education and Research HospitalIstanbul, Turkey
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Abstract
Many techniques are described for the ligation of a difficult cystic duct (CD). The aim of this study is to assess the effectiveness and safety of stapling of a difficult CD in acute cholecystitis using Endo-GIA. From January 2008 to June 2012, 1441 patients with cholelithiasis underwent laparoscopic cholecystectomy (LC) at the Department of General Surgery, Haydarpasa Numune Education and Research Hospital. Of these, 19 (0.62%) were identified as having a difficult CD and were ligated using an Endo-GIA stapler. All patients were successfully treated with a laparoscopic approach. The length of hospital stay was 3.4 days. There were umbilical wound infections in 4 patients (21%). The length of follow-up ranged from 1.0 to 50.4 months. In conclusion, Endo-GIA is a safe and easy treatment method for patients with a dilated and difficult CD. The cystic artery should be isolated and ligated if possible before firing the Endo-GIA stapler. If isolation and stapling are not possible, fibrin sealant can be applied to avoid bleeding. The vascular Endo-GIA can be applied in a large CD, but for acute cholecystitis with an edematous CD, the Endo-GIA roticulator 4.8 or 3.5 stapler is preferred.
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Affiliation(s)
- Mehmet Odabasi
- 1 Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey
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Odabasi M, Arslan C, Akbulut S, Abuoglu HH, Ozkan E, Yildiz MK, Eris C, Gunay E, Tekesin K, Muftuoglu T. Long-term effects of forgotten biliary stents: a case series and literature review. Int J Clin Exp Med 2014; 7:2045-2052. [PMID: 25232385 PMCID: PMC4161545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 07/27/2014] [Indexed: 06/03/2023]
Abstract
There are many studies about the biliary stents, however there is a little information about the long-term stayed forgotten biliary stents except a few case reports. We have reported the results of a number of cases with biliary stents that were forgotten or omitted by the patient and the endoscopist. During February 2010 to May 2013, five patients were referred to the general surgery clinic of Haydarpasa Numune Training and Research Hospital, Istanbul Turkey. Past history and medical documents submitted by the patient did not indicate a replacement of the biliary stent in 3 patients. Two patients knew that they had biliary stents. We also conducted a literature review via the PubMed and Google Scholar databases of English language studies published until March 2014 on forgotten biliary stent. There were 3 men and 2 women ranging in age from 22 to 68 years (mean age 41.6 years). Patients presented with pain in the upper abdomen, jaundice, fever, abnormal liver function tests or dilatation of the biliary tract alone or in combination. Patients' demographic findings are presented in Table 1. A review of three cases reported in the English medical literature also discussed. The mean duration of the patency of the stent is about 12 months. The biliary stenting is performed either with plastic or metal stents, studies recommending their replacement after 3-6 months. Patients with long stayed forgotten biliary stents are inevitably treated with surgical intervention. We recommend for all endoscopic retrograde cholangiopancreatography units provide a stent registry system that the stents placed for various therapeutic procedures are not forgotten both by the patient as well as the physician. There should be a deadline for biliary stents in the registry system for each patient.
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Affiliation(s)
- Mehmet Odabasi
- Department of Surgery, Haydarpasa Education and Research Hospital34688, Istanbul, Turkey
| | - Cem Arslan
- Department of Surgery, Haydarpasa Education and Research Hospital34688, Istanbul, Turkey
| | - Sami Akbulut
- Department of Surgery, Diyarbakir Education and Research Hospital21400, Diyarbakir, Turkey
| | - Haci Hasan Abuoglu
- Department of Surgery, Haydarpasa Education and Research Hospital34688, Istanbul, Turkey
| | - Erkan Ozkan
- Department of Surgery, Haydarpasa Education and Research Hospital34688, Istanbul, Turkey
| | - Mehmet Kamil Yildiz
- Department of Surgery, Haydarpasa Education and Research Hospital34688, Istanbul, Turkey
| | - Cengiz Eris
- Department of Surgery, Haydarpasa Education and Research Hospital34688, Istanbul, Turkey
| | - Emre Gunay
- Department of Surgery, Haydarpasa Education and Research Hospital34688, Istanbul, Turkey
| | - Kemal Tekesin
- Department of Surgery, Haydarpasa Education and Research Hospital34688, Istanbul, Turkey
| | - Tolga Muftuoglu
- Department of Surgery, Haydarpasa Education and Research Hospital34688, Istanbul, Turkey
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Odabasi M, Gokdemir S, Muftuoglu T, Aktekin A, Saglam A, Aker F. Prophylactic and therapeutic effects of oral budesonide for acute radiation-induced enteritis and colitis in rats. Int J Clin Exp Med 2014; 7:940-946. [PMID: 24955165 PMCID: PMC4057844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 04/15/2014] [Indexed: 06/03/2023]
Abstract
No satisfactory means has been found to control the symptoms of diarrhea and weight loss caused by radiation-induced enteritis and colitis. As a glucocorticoid, budesonide has multiple effects, and this study aimed to test whether it could be effective in treating these symptoms. Twenty-eight male Wistar albino rats were randomly allocated into 4 groups. Group I received 0.1 mg/kg/day budesonide at 8-h intervals for 5 days and did not undergo radiation. Group II received 0.1 mg/kg/day budesonide at 8-h intervals for 1 day before radiation treatment and 4 days after irradiation. Group III received 0.1 mg/kg/day budesonide at 8-h intervals for 4 days after irradiation. Group IV received only radiation treatment. On the fifth day after radiation treatment, the rats underwent laparotomy. The rats were weighed before irradiation and before laparotomy. Because of diarrhea, all rats lost weight except group I, which showed weight gain. Weight loss was statistically significant only in group IV. Group I rats exhibited a normal jejunum, ileum, and colon. The other groups showed varying degrees of damage. We conclude that, particularly when given before irradiation, budesonide decreased the side effects of radiation-induced enteritis and colitis both clinically and morphologically. Future pathophysiological and clinical studies will be needed to support this result.
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Affiliation(s)
- Mehmet Odabasi
- Department of Surgery, Haydarpasa Education and Research HospitalIstanbul, Turkey
| | - Suleyman Gokdemir
- Department of Surgery, Haydarpasa Education and Research HospitalIstanbul, Turkey
| | - Tolga Muftuoglu
- Department of Surgery, Haydarpasa Education and Research HospitalIstanbul, Turkey
| | - Ali Aktekin
- Department of Surgery, Haydarpasa Education and Research HospitalIstanbul, Turkey
| | - Abdullah Saglam
- Department of Surgery, Haydarpasa Education and Research HospitalIstanbul, Turkey
| | - Fugen Aker
- Department of Pathology, Haydarpasa Education and Research HospitalIstanbul, Turkey
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Yildiz MK, Okan I, Dursun N, Bas G, Alimoglu O, Kaya B, Odabasi M, Sahin M. Effect of orally administered simvastatin on prevention of postoperative adhesion in rats. Int J Clin Exp Med 2014; 7:405-410. [PMID: 24600496 PMCID: PMC3931595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 01/19/2014] [Indexed: 06/03/2023]
Abstract
AIM Formation of adhesions in the abdominal region appearing after abdominal pelvic surgery lead to infertility, chronic pelvic pain, intestinal obstructions, difficulty and morbidity at the following operations, and increased morbidity. The aim of our study is to examine the effectiveness of orally administered simvastatin on preventing the postoperative adhesion. MATERIALS AND METHODS 20 male Wistar Albino rats weighing 230-250 gr were used. The rats were housed for 12 hours day and 12 hours night cycles in cages and were divided into two groups, namely study and control group. Microscopic evaluation of adhesion was assessed under 5 main topics which are the signs of inflammatory response; inflammation, activation, fibroblast activity, vascularity, presence of giant cell. Activation was scored as follows: (0) no activation, (1) while activation was accepted as present the score for other parameters was evaluated between 0 to 3 according to the increased severity. After evaluating all topics separately, the average of all scores has been assessed in both groups. RESULTS As a result of the macroscopic evaluation of postoperative intra-abdominal adhesions, the percentage of adhesion in simvastatin applied group was found to be 0.8 ± 0.17. This value was calculated as 0.6 ± 0.2 in the control group. Regarding the severity of adhesion, while in the simvastatin applied group the value was found to be 9.1 ± 4, in the control group it was 6.8 ± 3. The general adhesion score was found to be 7.7 ± 4.2 in simvastatin applied group and 5.1 ± 3.7 in control group. CONCLUSION In this experimental study it was showed that orally administered simvastatin has no significant effect on preventing formation of postoperative adhesions.
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Affiliation(s)
- Mehmet Kamil Yildiz
- Department of General Surgery, Haydarpasa N. Training and Research HospitalTurkey
| | - Ismail Okan
- Department of General Surgery, Osmangazi University Medical FacultyTurkey
| | - Nevra Dursun
- Department of Pathology, Istanbul Training and Research HospitalTurkey
| | - Gurhan Bas
- Department of Pathology, Istanbul Training and Research HospitalTurkey
| | - Orhan Alimoglu
- Department of General Surgery, Medeniyet University Medical FacultyTurkey
| | - Bulent Kaya
- Department of General Surgery, Haydarpasa N. Training and Research HospitalTurkey
| | - Mehmet Odabasi
- Department of General Surgery, Haydarpasa N. Training and Research HospitalTurkey
| | - Mustafa Sahin
- Department of General Surgery, Osmangazi University Medical FacultyTurkey
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Odabasi M, Arslan C, Abuoglu H, Gunay E, Yildiz MK, Eris C, Ozkan E, Aktekin A, Muftuoglu MAT. An unusual presentation of perforated appendicitis in epigastric region. Int J Surg Case Rep 2013; 5:76-8. [PMID: 24441442 PMCID: PMC3921649 DOI: 10.1016/j.ijscr.2013.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 11/07/2013] [Accepted: 12/05/2013] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Atypical presentations of appendix have been reported including backache, left lower quadrant pain and groin pain from a strangulated femoral hernia containing the appendix. We report a case presenting an epigastric pain that was diagnosed after computed tomography as a perforated appendicitis on intestinal malrotation. PRESENTATION OF CASE A 27-year-old man was admitted with a three-day history of epigastric pain. Physical examination revealed tenderness and defense on palpation of epigastric region. There was a left subcostal incision with the history of diaphragmatic hernia repair when the patient was 3 days old. He had an intestinal malrotation with the cecum fixed at the epigastric region and the inflamed appendix extending beside the left lobe of liver. DISCUSSION While appendicitis is the most common abdominal disease requiring surgical intervention seen in the emergency room setting, intestinal malrotation is relatively uncommon. When patients with asymptomatic undiagnosed gastrointestinal malrotation clinically present with abdominal pain, accurate diagnosis and definitive therapy may be delayed, possibly increasing the risk of morbidity and mortality. CONCLUSION Atypical presentations of acute appendicitis should be kept in mind in patients with abdominal pain in emergency room especially in patients with previous childhood operation for diaphragmatic hernia.
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Affiliation(s)
- Mehmet Odabasi
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul 34688, Turkey.
| | - Cem Arslan
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul 34688, Turkey
| | - Hasan Abuoglu
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul 34688, Turkey
| | - Emre Gunay
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul 34688, Turkey
| | - Mehmet Kamil Yildiz
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul 34688, Turkey
| | - Cengiz Eris
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul 34688, Turkey
| | - Erkan Ozkan
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul 34688, Turkey
| | - Ali Aktekin
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul 34688, Turkey
| | - M A Tolga Muftuoglu
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul 34688, Turkey
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Odabasi M, Yildiz MK, Abuoglu HH, Eris C, Ozkan E, Gunay E, Aktekin A, Muftuoglu MAT. A modified Rendezvous ERCP technique in duodenal diverticulum. World J Gastrointest Endosc 2013; 5:568-573. [PMID: 24255749 PMCID: PMC3831199 DOI: 10.4253/wjge.v5.i11.568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 10/09/2013] [Accepted: 11/05/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To postoperative endoscopic retrograde cholangiopancreatography (ERCP) failure, we describe a modified Rendezvous technique for an ERCP in patients operated on for common bile duct stone (CBDS) having a T-tube with retained CBDSs.
METHODS: Five cases operated on for CBDSs and having retained stones with a T-tube were referred from other hospitals located in or around Istanbul city to the ERCP unit at the Haydarpasa Numune Education and Research Hospital. Under sedation anesthesia, a sterile guide-wire was inserted via the T-tube into the common bile duct (CBD) then to the papilla. A guide-wire was held by a loop snare and removed through the mouth. The guide-wire was inserted into the sphincterotome via the duodenoscope from the tip to the handle. The duodenoscope was inserted down to the duodenum with a sphincterotome and a guide-wire in the working channel. With the guidance of a guide-wire, the ERCP and sphincterotomy were successfully performed, the guide-wire was removed from the T-tube, the stones were removed and the CBD was reexamined for retained stones by contrast.
RESULTS: An ERCP can be used either preoperatively or postoperatively. Although the success rate in an isolated ERCP treatment ranges from up to 87%-97%, 5%-10% of the patients require two or more ERCP treatments. If a secondary ERCP fails, the clinicians must be ready for a laparoscopic or open exploration. A duodenal diverticulum is one of the most common failures in an ERCP, especially in patients with an intradiverticular papilla. For this small group of patients, an antegrade cannulation via a T-tube can improve the success rate up to nearly 100%.
CONCLUSION: The modified Rendezvous technique is a very easy method and increases the success of postoperative ERCP, especially in patients with large duodenal diverticula and with intradiverticular papilla.
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Odabasi M, Yildiz KM, Cengiz E, Hasan AH, Gunay E, Ozkan E, Aktekin A, Kaya B, Muftuoglu TMA. Treatment of ampullary neuroendocrine tumor by endoscopic snare papillectomy. Am J Case Rep 2013; 14:439-43. [PMID: 24179583 PMCID: PMC3813632 DOI: 10.12659/ajcr.889601] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 08/19/2013] [Indexed: 12/20/2022]
Abstract
Patient: Female, 45 Final Diagnosis: Neuroendocrine tumor Symptoms: Abdominal pain Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology
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Affiliation(s)
- Mehmet Odabasi
- Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul,Turkey
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Abstract
The benefits and risks of surgery for splenic hydatid cyst (SHC) remain controversial. We aimed to share our experience about a surgical approach for SHC. Sixteen consecutive patients with SHC disease who underwent open splenectomy at our hospital between January 2006 and July 2012 were retrospectively evaluated. Data on the patients' demographic features, clinical findings, radiological and serological diagnostic methods, and surgical and medicinal treatment options were collected and used to generate descriptive profiles of diagnosis, treatment course, and outcome. The patient population was composed of 6 females and 10 males, with an age range of 18 to 79 years (mean age: 47.0 ± 18.0). Radiological examinations detected hydatid cysts in spleen alone (n = 7) or both spleen and liver (n = 9). Preoperative serological testing identified 13 of the patients as IHA positive. All except 1 patient received a 10- to 21-day preoperative course of albendazole therapy and all patients received vaccination 1 week prior to surgery. Seven patients underwent splenectomy. The remaining patients underwent splenectomy with partial cystectomy and omentopexy (n = 6), partial cystectomy and unroofing (n = 1), pericystectomy (n = 1), or pericystectomy with partial nephrectomy (n = 1). All except one patient received a 10- to 45-day postoperative course of albendazole. No patients developed serious complications or signs of recurrence during the follow-up. The clinical profile of SHC disease at our hospital includes diagnosis by radiological methods, splenectomy treatment by simple or concomitant procedures according to the patient's symptoms, cyst size, number and localization, and compression of adjacent organs, and adjunct vaccination to decrease risk of postoperative septic complications. This profile is associated with low risk of complications and high therapeutic efficacy.
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Affiliation(s)
- Cengiz Eris
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Sami Akbulut
- Department of Surgery, Diyarbakir Education and Research Hospital, 21400, Diyarbakir, Turkey
| | - Mehmet Kamil Yildiz
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Hasan Abuoglu
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Odabasi
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Erkan Ozkan
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Suleyman Atalay
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Emre Gunay
- Department of Surgery, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
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Aktekin A, Gurleyik G, Odabasi M, Muftuoglu T, Saglam A. Trans-cystic biliary catheterization and decompression in liver and biliary surgery. Hepatogastroenterology 2013; 60:985-988. [PMID: 23491927 DOI: 10.5754/hge11015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND/AIMS Trans-cystic biliary catheterization (TCBC) and decompression may be employed to prevent biliary leakage after liver and biliary surgery. METHODOLOGY We evaluated medical records of patients that required trans-cystic biliary catheterization between 2001-2009; we retrospectively review prospectively collected data, including patient demographics, operational procedures, cholangiographies and post-operative follow-ups. RESULTS Mean age was 54 years (16-80 years) and 63% of patients were female. TCBC was employed only during the operation in 13 patients due to biliary leakage suspicion, but no leakage was detected and cystic canal is ligatured after catheter removal at the same operation. In remaining patients, catheters were placed in the cystic duct and blocked in 1-12 days. Biliary fistula developed in five patients and bile leakage was stopped spontaneously under trans-cystic biliary catheterization and decompression. Three patients were diagnosed to have retained common bile duct stones by cholangiographies and all removed with endoscopic retrograde cholangiopancreatography. Catheters were withdrawn at 19-21 days post-operation. We experienced no TCBC related complications. CONCLUSIONS Despite risks and difficulty of TCBC, it helps to demonstrate bile leak sites via trans-cystic flushing and to repair them as well as taking cholangiography, recognizing intra-luminal pathology, and also decompressing biliary system.
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Odabasi M, Eris C, Yildiz MK, Abuoglu H, Akbulut S, Saglam A. Splenic artery transposition graft usage for the supply of the right hepatic artery: a case report. Int Surg 2013; 98:277-81. [PMID: 23971784 PMCID: PMC3756853 DOI: 10.9738/intsurg-d-13-00006.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Hepatic artery aneurysms are responsible for 12% to 20% of all visceral arterial aneurysms. Because most patients are asymptomatic, this disease is generally diagnosed incidentally during radiologic examination. Aneurysm rupture develops in 14% to 80% of cases, depending on the aneurysmatic segment's diameter and location, as well as other etiologic factors. Mortality rates associated with rupture range between 20% and 70%. Thus, early diagnosis and timely initiation of medical interventions are critical to improve survival rates. Here, we present a male patient, age 69 years, with a hepatic artery aneurysm that was detected incidentally. The 3-cm aneurysm was detected on contrast-enhanced computed tomography and extended from the common hepatic artery to the hepatic trifurcation. A laparotomy was performed using a right subcostal incision. After dissection of the hepatoduodenal ligament, the common, right, and left hepatic arteries, as well as the gastroduodenal artery, were suspended separately. Then, the aneurysmatic hepatic artery segment was resected, and the gastroduodenal artery stump was ligated. An end-to-end anastomosis was formed between the left and common hepatic arteries, followed by an end-to-end anastomosis formed between the right hepatic artery and splenic artery using a splenic artery transposition graft. Postoperative follow-up examinations showed that both hepatic arterial circulations were good, and no splenic infraction had developed.
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Affiliation(s)
- Mehmet Odabasi
- Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey
| | - Cengiz Eris
- Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Kamil Yildiz
- Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey
| | - Hasan Abuoglu
- Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey
| | - Sami Akbulut
- Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Abdullah Saglam
- Department of Surgery, Haydarpasa Education and Research Hospital, Istanbul, Turkey
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Eris C, Yildiz MK, Odabasi M, Akbulut S, Abuoglu H, Ozkan E. Gastric outlet obstruction caused by focal nodular hyperplasia of the liver: A case report and literature review. Int J Surg Case Rep 2013; 4:681-3. [PMID: 23792480 PMCID: PMC3710892 DOI: 10.1016/j.ijscr.2013.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 04/20/2013] [Accepted: 05/12/2013] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Here, we present a case of gastric outlet obstruction due to focal nodular hyperplasia of the liver. PRESENTATION OF CASE A 23-year-old female presented to our emergency clinic with nausea, vomiting, and abdominal pain. Endoscopy showed that the prepyloric region of the stomach was externally compressed by a lesion. Computed tomography and magnetic resonance imaging revealed a 70mm solid mass originating from the liver, extending caudally in an exophytic manner, and compressing the stomach. Laparotomy revealed an irregular and exophytic mass originating from the liver, which caused gastric outlet obstruction. The mass was resected with a 10mm safety margin. The histopathology report of the mass returned as focal nodular hyperplasia. DISCUSSION Gastric outlet obstruction is a clinical syndrome characterized by abdominal pain, nausea, and postprandial vomiting. This clinical condition frequently develops as a result of peptic ulcer disease, pyloric stenosis, and obstruction of pylorus by foreign bodies including phytobezoars, congenital duodenal webs, malignant disorders, and various lesions externally compressing the stomach. Gastric outlet obstruction due to hepatic lesions is extremely rare; few cases have been reported. CONCLUSION This is the first reported case of gastric outlet obstruction that developed due to focal nodular hyperplasia of the liver.
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Affiliation(s)
- Cengiz Eris
- Department of Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Kamil Yildiz
- Department of Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Odabasi
- Department of Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Sami Akbulut
- Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir 21400, Turkey
- Corresponding author. Tel.: +90 412 2580050; fax: +90 412 2580052.
| | - Hasan Abuoglu
- Department of Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Erkan Ozkan
- Department of Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Muftuoglu MAT, Gungor O, Odabasi M, Ekinci O, Teyyareci A, Sekmen U, Saglam A. The comparison of heavyweight mesh and lightweight mesh in an incisional animal model. Hernia 2010; 14:397-400. [PMID: 20229105 DOI: 10.1007/s10029-010-0647-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Accepted: 02/15/2010] [Indexed: 01/05/2023]
Abstract
PURPOSE An incisional hernia may occur through the incision area following a surgical operation, through the trocar opening and even through drainage exit points. Various synthetic surgical meshes have recently been used for the surgical repair of incisional hernias. In this study, we analysed the burst strength forces of heavyweight mesh and lightweight mesh in an incisional animal model. METHODS Following experimental formation of incisional hernias in 32 Wistar albino rats, they were divided into four groups. Polypropylene suture was used for closure of the abdominal incision in Group 1. In Groups 2, 3 and 4, polyester, polypropylene + polyglactin and polypropylene meshes, respectively, were fixed on the surface of the fascia after closing the defects in the rats. Polypropylene and polyester meshes are classified as heavy mesh. Light mesh is composed of a non-absorbable part (polypropylene) and an absorbable part (polyglactin), which will disappear 80 days after implantation. The rats were sacrificed at the end of the experiment. The pullout force of the fascia and meshes were recorded by use of a digital tension meter. RESULTS The mean pullout forces for Groups 1, 2, 3 and 4 were found to be 123.4 +/- 13.3, 292.33 +/- 17.4, 281.66 +/- 16.3 and 310.60 +/- 26.1 N, respectively. CONCLUSION At the end of the experiment, the polypropylene (25 g/cm(2)) present in the lightweight mesh was found to lose only a small percentage of the burst strength compared to the polypropylene (85 g/cm(2)) present in the heavyweight mesh.
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Affiliation(s)
- M A T Muftuoglu
- Fourth Department of General Surgery, Haydarpaşa Numune Research and Training Hospital, Usküdar, Istanbul, Turkey.
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