Management Approach of Cholangiocarcinoma of Middle Third Bile Duct

Background: Prognosis of middle third cholangiocarcinoma according of recent studies remains poor. However, identifying survival predictors, mentioned a few; stage and patients age, still should take place in clinical practices especially for minor medical facility centers. Case presentation: A 75 years old lady, was assessed and diagnosed with middle third cholangiocarcinoma, patients underwent from laboratory workup; where SGOT, SGPT were almost threefold elevated, as well Total bilirubin, direct and indirect, were four to tenfold higher than normal levels. CRP as well was seen tenfold higher than normal levels. MRCP was seen dilated of biliary ducts, dilatation of common hepatic duct, narrowing of common hepatic and ductus choledochus that goes with cholangiocarcinoma aspect. Thickness of junction lumen with solid mass 7 mm, infiltrates totally the wall that created the blockage, with increased of contrast intake, no infiltration of pancreas head is seen. Closeness of mass with the vena porta There were seen two lymph nodes less than 1 cm in gastro hepatic ligament. No infiltration of inferior vena cava, common pancreatic ductus normal. No infiltration of superior mesenteric vena. After multidisciplinary consultation and patient’s decision informed consent was completed, personalized patients’ treatment was performed, surgical intervention, biopsy and then adjuvant chemotherapy was applied, with a 3-year survival and quality life was achieved. Conclusions: even in advanced cases of highly malignant cases like cholangiocarcinoma, even most of authors and surgeons agree in low survival rate according to study data, we should create a personalized strategy treatment of each patient in order to increase survival and quality of life as well Keywords: Cholangiocarcinoma, surgical, chemotherapy, personalized treatment DOI: 10.7176/ALST/93-06 Publication date: April 30th 202

Necrotizing Fasciitis as an Early Postoperative Complication of Non-perforated Non-metastatic Rectal Cancer: Case Report and a Review of the Literature

Background: Necrotizing fasciitis is a life-threatening condition characterized by a rapid onset and aggressive degradation of the patient’s condition due to its fair prognosis. The brisk rate of necrotizing fasciitis evolution often makes diagnosing and treating it difficult, thus becoming fatal and incompatible with life. Case report: The authors report a rare case of a 62 years old woman, who had undergone a laparoscopic anterior rectal resection intervention. The patient presented stable with no co-morbidities. She had suffered different gastrointestinal symptoms during the last 2 months such as anorexia, diarrhea, and abdominal discomfort. She had also lost 6 kg in a 2-month time period. Imaging examinations (contrast CT) detected a rectal tumor stage CT4a N1 M0. No bowel perforations were detected. The team faced no perioperative complications. Later that day, she referred to having moderated pain around the surgical wounds that developed two days later with pain and mild diffuse hematoma in the left flank. This developed into necrotizing fasciitis and despite all the efforts she had an exitus lethalis on the 9th postoperative day. Conclusions: Necrotizing fasciitis still remains a challenge to many specialists. In the context of malignancies, it is sometimes seen as a complication of perforated colon tumors. However, cases such as this, represent a challenge to many doctors due to their insidious characteristics. That is why it is important to search further into the mechanisms of this pathology. Keywords: necrotizing fasciitis, colorectal cancer, postoperative complication. DOI: 10.7176/ALST/96-01 Publication date: December 31st 202

The 6th Albanian Congress of Trauma and Emergency Surgery

After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is organizing to gather all health professionals in Tirana, The 6th Albanian Congress of Trauma and Emergency Surgery(ACTES 2022) on 11-12 November 2022, with the topic Trauma & Emergency Surgery and not only...with the aim of providing high quality, the best standards, and the best results, for our patients ...ACTES 2022 is the largest event that ASTES (Albanian Society for Trauma and Emergency Surgery) has organized so far with 230 presentations, and 67 foreign lecturers with enviable geography, making it the largest national and wider scientific event.The scientific program is as strong as ever, thanks to the inclusiveness, where all the participants with a mix of foreign and local lecturers, select the best of the moment in medical science, innovation, and observation.The scientific committee has selected all the presentations so that the participants of each medical discipline will have something to learn, discuss, debate, and agree with updated methods, techniques, and protocols.I hope you will join us on Friday morning, and continue the journey of our two-day event together