Revision bariatric surgery. What technical choices should be taken depending on the first intervention?

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Treatment options for PNET liver metastases. a systematic review

Pancreatic neuroendocrine tumors (PNETs) are rare pancreatic neoplasms. About 40-80% of patients with PNET are metastatic at presentation, usually involving the liver (40-93%). Liver metastasis represents the most significant prognostic factor. The aim of this study is to present an up-to-date review of treatment options for patients with liver metastases from PNETs

Pneumatosis cystoidis intestinalis presenting as bowel perforation, a rare entity

AbstractIntroductionPneumatosis cystoides intestinalis (PCI) is an uncommon condition. This following article describes a case of primary PCI presenting as acute abdomen due to perforation of a small bowel cyst.Presentation of caseThis following article describes the case of an 88 year-old woman admitted at the hospital with peritonitis and consequently operated for a presumed bowel ischemia and perforation. However surgical exploration revealed perforated PCI.DiscussionThe pathophysiology of secondary PCI is poorly understood. Gas produced by Gas-forming bacteria may enter the mucosal barrier due and consequently this gas accumulates within the bowel wall. Also malnutrition can prevent the digestion of carbohydrates, which leads to increased bacterial fermentation, and production of large volumes of gas leading to distention and ischemia and subsequently the submucosal dissection of gas. Colonoscopy is helpful in excluding other colonic lesions and it shows the submucosal cysts that have a typical dual appearance: multiple white small cysts coupled to a sub-atrophic mucosa or larger cysts (up to 3cm) with a reddened overlying mucosa.ConclusionThe treatment unless complicated should be conservative even in the presence of pneumoperitoneum, after excluding complications

Postoperative Pancreatic Fistula. Is Minimally Invasive Surgery Better than Open? A Systematic Review and Meta-analysis

Background/Aim: Minimally invasive pancreatico-duodenectomy (PD) is gaining popularity. The aim of this study was to compare the incidence of postoperative pancreatic fistula (POPF) after minimally invasive versus open procedures. Materials and Methods: Following the PRISMA statement, literature research was conducted focusing on papers comparing the incidence of POPF after open pancreaticoduodenectomy (OPD) versus minimally invasive pancreaticoduodenectomy (MIPD). Results: Twenty-one papers were included in this meta -analysis, for a total of 4,448 patients. A total of 2,456 patients (55.2%) underwent OPD, while 1,992 (44.8%) underwent MIPD. Age, ASA score III patients, incidence of pancreatic ductal adenocarcinoma and duct diameter were significantly lower in the MIPD group. No statistically significant differences were found between the OPD and MIPD regarding the incidence of major complications (15.6% vs. 17.0%, respectively, p=0.55), mortality (3.7% vs. 2.4%, p=0.81), and POPF rate (14.3% vs. 12.9%, p=0.25). Conclusion: MIPD and OPD had comparable rates of postoperative complications, postoperative mortality, and POPF

Painful Perineal Mass. What Is the Diagnosis?

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De Garengeot's hernia. Radiological and intraoperative imaging

No abstract availabl

One Anastomosis Gastric Bypass with an Afferent Limb of 150 cm and Postoperative Reflux

No abstract availabl

Should obesity be considered a contraindication to mini-invasive pancreaticoduodenectomy?

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