Prevention of inadvertent injury to aberrant hepatic artery arising from superior mesenteric artery during laparoscopic pancreaticoduodenectomy.

Laparoscopic pancreatoduodenectomy is a challenging surgical procedure. Presence of aberrant hepatic artery arising from the superior mesenteric artery increases the complexity througout dissection. Herein we propose some important points and tricks that help surgeon avoid an inadverdent injury to aberrant hepatic artery during laparoscopic pancreatoduodenectomy

Modified Makuuchi incision in the surgical treatment of renal tumors: Initial results.

To evaluate the modified Makuuchi incision in the surgical treatment of renal tumors

Investigation of the effects of thymoquinone on erythrocyte deformability in sepsis treatment which created by cecal perforation in rat

AIM: We aimed to study the effects of thymoquinone on erythrocyte deformability in an experimental model of sepsis given before or after the initiation of the sepsis model

The Correlation Between Serum Adiponectin Levels and Proinflammatory Cytokines’ Levels, APACHE-II Scores and Mortality in Patients with Intra-Abdominal Sepsis

Objectives: Adiponectin is an anti-inflammatory cytokine that is abundantly produced by adipocytes and have a wide range of effects in sepsis pathophysiology. This study was conducted to investigate whether there is a correlation between serum adiponectin, proinflammatory cytokines’ levels, APACHE-II scores and mortality rates of the patients with sepsis, severe sepsis and septic shock. Patients and Methods: Forty-five patients who met the criteria for sepsis (n=18), severe sepsis (n=14) and septic shock (n=13) were included in this prospective study. Patients who underwent elective abdominal surgery without sepsis were identified as the control group. After the diagnosis of sepsis, blood samples were taken on the following 5 days for adiponectin, IL-6, IL-1β, TNF-α and procalcitonin levels. APACHE-II scores of the patients were calculated daily. All patients were followed for 28 days and mortalities were observed. Results: Ten of the patients died within 28 days. The serum adiponectin levels of the patients in the study group were statistically higher than those in the control group. Statistically, the adiponectin levels of the patients in the septic shock group were markedly lower than those of the patients in sepsis and severe sepsis groups. Serum adiponectin levels inversely correlated with blood levels of IL-6, IL-1β, TNF-α, procalcitonin, lactate and APACHE-II scores. Serum adiponectin levels were significantly higher in survivors. Conclusion: Adiponectin levels reveal differences between sepsis, severe sepsis and septic shock groups. In patients with septic shock, serum adiponectin levels were associated with mortality among patients. Serum adiponectin levels might be a negative predictive marker in patients with sepsis, severe sepsis and septic shock

Increased Resistin Levels in Intra-abdominal Sepsis : Correlation with proinflammatory cytokines & Acute Physiology & Chronic Health Evaluation II scores

Objectives: Resistin, a hormone secreted from adipocytes and considered to be a likely cause of insulin resistance, has recently been accepted as a proinflammatory cytokine. This study aimed to determine the correlation between resistin levels in patients with intra-abdominal sepsis and mortality. Methods: Of 45 patients with intraabdominal sepsis, a total of 35 adult patients were included in the study. This study was undertaken from December 2011 to December 2012 and included patients who had no history of diabetes mellitus and who were admitted to the general surgery intensive care units of Gazi University and Bülent Ecevit University School of Medicine, Turkey. Evaluations were performed on 12 patients with sepsis, 10 patients with severe sepsis, 13 patients with septic shock and 15 healthy controls. The patients’ plasma resistin, interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), procalcitonin, lactate and glucose levels and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were studied daily for the first five days after admission. A correlation analysis of serum resistin levels with cytokine levels and APACHE II scores was performed. Results: Serum resistin levels in patients with sepsis were significantly higher than in the healthy controls (P <0.001). A significant correlation was found between serum resistin levels and APACHE II scores, serum IL-6, IL-1β, TNF-α, procalcitonin, lactate and glucose levels. Furthermore, a significant correlation was found between serum resistin levels and all-cause mortality (P = 0.02). Conclusion: The levels of resistin were significantly positively correlated with the severity of disease and were a possible mediator of a prolonged inflammatory state in patients with intra-abdominal sepsis