Pancreatic remnant fate

There is eternal discussion on the best surgical method of pancreatoduodenectomy and reconstruction method. Several different methods of pancreatic stump anastomosis exist. The most popular argument taken into account in the discussion is the frequency of early postoperative complications. Relatively fewer papers analyse the late functional outcome of pancreatic surgery and the method of anastomosis employed. Authors presented short series of 12 patients after pancreatic surgery with analysis of pancreatic remnant morphology and function. Pancreatic remnant volume, pancreatic duct distension and stool elastase-1 test were analysed. There was no correlation of pancreatic exo- or endocrine insufficiency with the volume of pancreatic remnant or the kind of surgery or anastomosis performed

The morphology of acinar cells during acute pancreatitis in rats induced by intraductal infusion of peracetate

Many experimental models have been created to explain the pathophysiology of acute pancreatitis (AP). Investigations have been undertaken in this laboratory into the influence of strong oxidants introduced into the pancreas retrogradely through the bile-pancreatic duct. In these experiments a potentially toxic metabolite of ethanol-peracetic acid was used to induce AP. Wistar rats were treated with 1 mM and 40 mM peracetate and with a solvent as a control for 1 and 3 hours respectively. After a period of observation the samples of pancreata were examined in a light and electron microscope together with the content of sulphydryl groups as a marker of intracellular oxidative stress. The morphological examination showed profound changes in the histology of the pancreas and also in its subcellular structures, especially in groups 3 and 4 (with a higher concentration of peracetate). The changes included parenchymal haemorrhage and widespread acinar cell necrosis. The level of the sulphydryl groups decreased in the rats treated with peracetate. This suggests that the severity of the disease strongly depends on the intensity of the oxidative stress. The results confirmed the axial role of oxygen-derived free radicals in the pathogenesis of AP

Are mesh anchoring sutures necessary in ventral hernioplasty? Multicenter study

Background: Avoiding mesh fixation to the surrounding tissue in ventral hernioplasty would simplify the operation, decrease the time of the procedure, and decrease the risk of suture-related complications. Methods: Four hospitals included 111 patients according to the common protocol for prospective clinical evaluation of sutureless ventral hernioplasty. Surgical technique involves placement of the polypropylene mesh with flat-shape memory in either the retromuscular or preperitoneal space without suture anchoring. Results: Local complication rate was low (12.6%, 14 patients), postoperative pain measured according to the visual analogue scale was minimal (mean 4, range 1-8). Three recurrences (3%) were recorded. Mild scar discomfort, which did not require treatment nor limit physical activity, was recorded in 28 (25%), 18 (17%), and 11 (14%) patients at 6-month, 1- and 2-year follow-up, respectively. Conclusions: Results ofthe study suggest that the sutureless sublay technique is safe and effective in the treatment of ventral abdominal hernia, especially in small and medium defects. © Springer-Verlag 2007

Are mesh anchoring sutures necessary in ventral hernioplasty? Multicenter study

Background: Avoiding mesh fixation to the surrounding tissue in ventral hernioplasty would simplify the operation, decrease the time of the procedure, and decrease the risk of suture-related complications. Methods: Four hospitals included 111 patients according to the common protocol for prospective clinical evaluation of sutureless ventral hernioplasty. Surgical technique involves placement of the polypropylene mesh with flat-shape memory in either the retromuscular or preperitoneal space without suture anchoring. Results: Local complication rate was low (12.6%, 14 patients), postoperative pain measured according to the visual analogue scale was minimal (mean 4, range 1-8). Three recurrences (3%) were recorded. Mild scar discomfort, which did not require treatment nor limit physical activity, was recorded in 28 (25%), 18 (17%), and 11 (14%) patients at 6-month, 1- and 2-year follow-up, respectively. Conclusions: Results ofthe study suggest that the sutureless sublay technique is safe and effective in the treatment of ventral abdominal hernia, especially in small and medium defects. © Springer-Verlag 2007

Are mesh anchoring sutures necessary in ventral hernioplasty? Multicenter study

Background: Avoiding mesh fixation to the surrounding tissue in ventral hernioplasty would simplify the operation, decrease the time of the procedure, and decrease the risk of suture-related complications. Methods: Four hospitals included 111 patients according to the common protocol for prospective clinical evaluation of sutureless ventral hernioplasty. Surgical technique involves placement of the polypropylene mesh with flat-shape memory in either the retromuscular or preperitoneal space without suture anchoring. Results: Local complication rate was low (12.6%, 14 patients), postoperative pain measured according to the visual analogue scale was minimal (mean 4, range 1-8). Three recurrences (3%) were recorded. Mild scar discomfort, which did not require treatment nor limit physical activity, was recorded in 28 (25%), 18 (17%), and 11 (14%) patients at 6-month, 1- and 2-year follow-up, respectively. Conclusions: Results ofthe study suggest that the sutureless sublay technique is safe and effective in the treatment of ventral abdominal hernia, especially in small and medium defects. © Springer-Verlag 2007