Open Surgery for Hepatic Hydatid Disease

Hydatid disease is a zoonosis caused by the larvae of Echinococcus granulosus. Humans are an intermediate host and are usually infected by direct contact with dogs or indirectly by contaminated foods. Hydatid disease mainly involves the liver and lungs. The disease can be asymptomatic. Imaging techniques such as ultrasonography and computed tomography are used for diagnosis. The growth of hydatid cysts can lead to complications. Communication between bile duct and cysts is a common complication. The goal of treatment for hydatid disease is to eliminate the parasite with minimum morbidity and mortality. There are 3 treatment options: surgery, chemotherapy, and interventional procedures. Medical treatment has low cure and high recurrence rates. Percutaneous treatment can be performed in select cases. There are many surgical approaches for managing hydatid cysts, although there is no best surgical technique, and conservative and radical procedures are used. Conservative procedures are usually preferred in endemic areas and are easy to perform but are associated with high morbidity and recurrence rates. In these procedures, the parasite is sterilized using a scolicidal agent, and the cyst is evacuated. Radical procedures include hepatic resections and pericystectomy, which have high intraoperative risk and low recurrence rates. Radical procedures should be performed in hepatobiliary centers. The most common postoperative complications are biliary fistulas and cavity-related complications. Endoscopic retrograde cholangiopancreatography can be used to diagnose and treat biliary system complications. Endoscopic sphincterotomy, biliary stenting, and nasobiliary tube drainage are effective for treating postoperative biliary fistulas

The Presence of Hemorrhagic Shock on Admission Is the Strongest Predictor of Mortality in Trauma Patients Who Require Packing

The aim of this study was to evaluate patients who had to be applied with packing because of abdominal trauma and to identify the factors affecting mortality from the findings on admission and the laboratory values that can be immediately examined. A retrospective analysis of 42 patients accepted to our level one trauma center between January 1998 and December 2017 was carried out. The patients were evaluated in respect of demographic characteristics, vital parameters, trauma type, injury severity score (ISS), the presence of additional injuries, transfusion amount, the need for intensive care, mortality rates, complications, the number and types of operations performed, the number of packings, the need for re-laparotomy, imaging methods, and radiological interventions. Of these parameters, the effects on mortality of findings on admission and the laboratory values that could be immediately tested were examined in particular. Packing was applied to 27 patients due to blunt trauma and to 15 patients due to penetrating trauma. Thirty-one patients had hypotension, and 24 of them had hemorrhagic shock status upon admission. Average ISS value was 34.5 +/- 9.9 (16-59). Twenty of the 42 patients died (47.6%). ISS level, hypotension, and hemorrhagic shock on admission were found to be significant risk factors of death in univariate analysis. In multivariate analysis however, only the presence of hemorrhagic shock was a statistically significant factor related to mortality. The presence of hemorrhagic shock on admission is a strong predictor of mortality in patients undergoing damage control surgery

Combined hepatocellular and cholangiocarcinoma associated with hepatolithiasis: Report of a case

Combined hepatocellular and cholangiocarcinoma is a rare form of primary hepatic carcinoma. We present a case of combined hepatocellular and cholangiocarcinoma coexisting with hepatolithiasis in a 53-year-old woman. The tumor was detected during surgery for the treatment of intrahepatic stones. A left hepatectomy was performed. A histologic examination of the specimen revealed typical features of combined hepatocellular and cholangiocarcinoma. Immunohistochemical analyses showed a biphenotypic antigen expression profile of the tumor cells. Risk factors commonly related to the development of this type of tumor include viral hepatitis and cirrhosis. This report describes an unusual etiologic factor that has not been reported previously

Surgical Treatment in Liver Cyst Hydatic Cases: Analysis of 276 Patients

Purpose: Hepatic hydatid disease is still a significant public health problem in Turkey. It is a parasitic infection, which liver is the most frequently infected organ. Surgical treatment has been controversial for a long time

Comparison of Proximal Versus Total Gastrectomy in the Surgical Treatment of Proximal Gastric Cancers

Objective: The shift in stomach cancer localization has led to new perspectives in the treatment of proximal one-third of the stomach cancer, focusing on the type of resection between total gastrectomy and proximal gastrectomy. We compared the results of patients with proximal gastric cancer, which were treated either with PG or TG regarding postoperative complications, symptoms of reflux esophagitis, the number of dissected lymph nodes, short-term survival, and the compliance to the postoperative planned diet

Feasibility of single-stage resection and primary anastomosis in patients with acute noncomplicated sigmoid volvulus

Background: The management of sigmoid volvulus remains controversial. The aim of this study was to evaluate the feasibility of treating sigmoid volvulus by using a single-stage resection and anastomosis versus a 2-stage approach

Retrograde intussusception into the jejuno-jejunal anastomosis

In this study, two cases of retrograde intussusception of distal efferent limb into jejuno-jejunal anastomosis are presented. To the best of our knowledge, these are the first two cases of jejuno-jejunal retrograde intussusception without gastric resection and a predisposing lesion. Patients was 37 and 33 year old men who were admitted with epigastric pain and vomiting for 2 and 3 days. Patients had a history of non-resective gastric surgery 6 and 11 years before admission due to peptic ulcus. In first and second case, manual reduction, and segmental resection with end-to-end anastomosis were performed, respectively

Effects of piperine in experimental intestinal ischemia reperfusion model in rats

BACKGROUND: Piperine is a spice principle, and its protective role against oxidative damage and lipid peroxidation has been reported. In this study, we aimed to investigate the effects of piperine in the prevention of ischemia-reperfusion injury to the small intestine

THE VALUE AND PROGNOSTIC SIGNIFICANCE OF PREOPERATIVE HEMOGLOBIN AND ALBUMIN LEVELS, AND THE LYMPHOCYTE AND PLATELET COUNT (HALP) SCORES IN PREDICTING PANCREATIC FISTULA IN PATIENTS UNDERGOING PANCREATICODUODENECTOMY DUE TO PERIAMPULLARY REGION TUMORS

Introduction.- The prognostic significance of the hemoglobin, albumlymphocyte and platelet(HALF) score has beert previously derytortstrated in 'Flatly types of malignant tumors. In this study, we aimed o determine the clinical value of MALE score in predicting postoperative pancreatic fistula and its relationship with survival patterns who underwent curative surgical resection due. to 1)eriampullary region tumors