Gallbladder melanoma mimicking acute acalculous cholecystitis. Surg Endosc. 2000 Jun;14(6):593. Epub 2000 May 8.

Gallbladder (GB) melanoma is a rare entity with a dismal prognosis. Its primary or secondary status is difficult to establish in the absence of an overt cutaneous localization. We report herein the case of a misdiagnosed GB melanoma mimicking acute acalculous cholecystitis that was treated by means of laparoscopic cholecystectomy (LC). A 54-year-old man was referred to our institution for acute cholecystitis. Apart from the ablation of some nevocytic nevi 7 years before admission, the patient's medical history was unremarkable. The ultrasound (US) examination showed a slightly enlarged acalculous gallbladder with thickened walls and a well-circumscribed polypoid mass in the fundus. The patient was treated medically and referred to LC. At surgery, some satellite nodules were visualized in the GB hepatic bed. The GB was removed, and two hepatic nodules were excised. Histology showed a pT3 melanoma. The patient underwent an open hepatic wedge resection 3 weeks after laparoscopy. No recurrence was observed at 6-month follow-up. To date, only one case of melanoma of the gallbladder treated with LC has been reported. GB melanoma is a diagnostic challenge when there is no evidence of a primary lesion. However, the occurrence of acalculous cholecystitis and a GB polyp in patients with a positive history of mole ablation should alert surgeons to the possibility of a melanoma

Laparoscopic approach to inguinal hernia pathology.

Laparoscopic hernia repair has already become as accepted a technique as the conventional ones and is routinely used in those centres where this kind of surgery is normally performed. The two most commonly used laparoscopic techniques (transabdominal and total extraperitoneal) have been shown to produce good results in terms of post-operative course and recurrence rates, but still present the disadvantages of high cost and the need for general anaesthesia. We report here a retrospective analysis of our early experience with laparoscopic treatment of inguino-crural hernias. The positive results achieved (no cases of conversion to an open technique; no recurrences to date; 4.7% major morbidity) allow us to consider this approach a valid alternative to the traditional ones in selected, well-informed patients

Repair of mucosa stomal prolapse with circular stapler. Technical note.

Mucosal stomal prolapse is a frequent complication of end colostomies. We describe here an original mucosal colostomy prolapse repair technique using a circular stapling device. This technique stems from the recent introduction of stapled muco-haemorrhoidectomy and was employed on a 68-year-old male patient who had undergone a Miles abdominoperineal excision 17 years earlier. On clinical inspection the patient presented a 5-cm. mucosal stomal prolapse on straining. The surgical procedure was performed under i.v. sedation with midazolam and propofol. After draping the abdomen, the stomal mucosa was gently everted with the aid of three Allis forceps, and a 1.0 prolene purse string suture was created 4-6 cm. cephalad to the cutaneous rim of the stoma. The head of a 33-mm circular stapler was introduced and the purse string suture was tied. The mechanical stapler was prepared and fired, thus obtaining a resection anastomosis of the prolapsed stomal mucosa. No bleeding occurred. A 24-F bladder catheter was placed cephalad to the stapled line and removed on postoperative day one. The patient was discharged from hospital the day after surgery. During a 16-month follow-up neither complications nor relapses have so far been observed. Our technique appears to be simple and safe. We believe it is indicated only for mucosal stomal prolapses, while full-thickness stomal prolapses should be managed by conventional techniques. A larger cohort of patients is needed to confirm our preliminary result

Effect of cryoextraction on phenols fractions of musts derived from white grape varieties

Effect of cryoextraction on phenols fractions of musts derived from white grape varietie

Ossigeno e condizionamento del redox nella elaborazione ed affinamento dei vini

Ossigeno e condizionamento del redox nella elaborazione ed affinamento dei vin

Resection of pulmonary metastases from colorectal carcinoma.

I.F.: 0,958 A retrospective study was made on 22 patients who underwent surgery (28 operations) for lung metastases of colorectal origin from 1986 to 1995 at the Department of Surgery II, Padova University. The overall 5-year survival (OS) following pulmonary resection was 62% and the 5-year disease-free interval after metastasectomy (DFIM) 45%. The median survival was 23.6 months and the median DFIM 15.3 months, Univariate (Mantel Cox) and multivariate (Cox's model) analyses were used to identify any prognostic factors significant for OS and DFIM. Site and stage of primary colorectal carcinoma, number of pulmonary metastases at presentation, disease-free intervals between treatment of primary tumour and diagnosis of lung metastases (DFIP) appeared to have no influence on OS and DFIM. However, patients who underwent radical resection for metastases had a significantly longer DFIM than those who underwent 'non-radical' resections (P = 0.02), but radical resection had no significant positive effect on OS, A short DFIP, multiple and/or bilateral lesions, lung metastases occurring after liver resection with a curative aim are not contraindications to surgery in patients with pulmonary metastases from colorectal cancer, the main criterion for selection of patients being the possibility of performing 'radical' resectio