12 research outputs found
Managing endoscopic retrograde cholangiopancreatography-related complications in patients referred to the surgical emergency unit
No full textBACKGROUND: The goal of this study was to present our experience in the management of endoscopic retrograde cholangiopan-creatography-related complications in patients referred to our surgical emergency unit by various endoscopy centers
Solid Pseudopapillary Neoplasm of the Pancreas: A Good Prognostic Tumor of the Bad Lucky Organ
No full textIntroduction Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare clinical entity with low malignant potential and good clinical prognosis. It was first defined by Frantz Virginia in 1959 and was renamed solid pseudopapillary tumor by the World Health Organization (WHO) in 2010. SPN is more common in young women with an average age of 28-32 years and a female: male ratio of 3-10:1 in different publications. Material & Method The data were retrospectively analyzed for 26 patients whose pathology was compatible with SPN and operated on between 2003 and 2019 in the General Surgery Clinic at XXX. Results Of the patients, 25 (96.2%) were female and 1 (3.8%) was male; the mean age at diagnosis was 37.1 (range: 18-69, eight patients <30 years); mean body mass index was 28.8 kg/m(2). The most common reason for referral was abdominal pain (n=13, 50%); three patients (11%) had nausea and vomiting, and one patient (3.8%) had jaundice with mass at the head of the pancreas. Ten patients (38%) were asymptomatic and were diagnosed incidentally during examinations performed for other reasons. The most frequent tumor localization was the head and neck part of the pancreas (n=10, 38%); eight patients (31%) had body, and eight patients (31%) had tail localization. Ten patients (38%) had Whipple procedure (pancreaticoduodenectomy), 15 patients (53%) had distal pancreatectomy, and one patient had intra-abdominal mass excision and segmental small bowel resection operation in addition to distal pancreatectomy. Six (37%) of the 16 patients who underwent distal pancreatectomy had splenectomy too. One of the patients had laparoscopic distal pancreatectomy and splenectomy. The mean tumor diameter was 7.2 cm (range: 2-23 cm). Conclusion SPN is a rare tumor, and even though it is diagnosed late and in large sizes, it has prolonged survival when appropriate surgical resection is applied. The ability to perform surgery even in cases with relapse or meta stasis during the SPN follow-up reveals the importance of accurate diagnosis
Absence of FcγRIII Results in Increased Proinflammatory Response in FcγRIII-KO Cardiac Recipients
No full textManagement of the Splenic Artery Aneurysm: with a Six Different Clinical Presentation and Treatment Modality
No full textSplenic artery aneurysm is the enlargement of the splenic artery more than 1 cm and can be a life-threatening condition. Trauma, pregnancy, portal hypertension, atherosclerosis, advanced age, and female gender are underlying risk factors. Although the patients are mostly asymptomatic, the symptoms may range from pain in the epigastrium, left upper quadrant, to sudden onset of severe abdominal pain and shock as a result of rupture. In our study, the data of six splenic artery aneurysm patients who applied to Istanbul University Cerrahpasa, Cerrahpasa Medical Faculty General Surgery Clinic, between 2015 and 2019 with different clinical presentations and treated with different methods were retrospectively analyzed. Six patients with splenic artery aneurysm were reviewed. They were 4 women and 2 men aged 28 to 66 years. The mean diameter of aneurysms was 4.42 cm and the average hospitalization duration was 6.8 days. All patients presented with abdominal pain. Two patients had also low hemoglobin value and hypovolemic shock due to intraabdominal bleeding. Splenic artery aneurysm rupture was diagnosed in 1 patient who was 28 weeks of gestation. Only aneurysmectomy was performed on 2 patients, aneurysmectomy + splenectomy on 3, and coil embolization on 1. Since splenic artery aneurysm may present with different clinical signs and may have high mortality due to the risk of rupture, it can be safely treated by using different modalities according to the patient's specifications after the appropriate and early diagnosis
Expanded-Criteria Donor Kidneys: A Single-Center Clinical and Short-Term Financial Analysis???Cause for Concern in Retransplantation
No full textInsulin Independence Following Isolated Islet Transplantation and Single Islet Infusions
No full textThe Role of Resolvin D1 in the Differential Diagnosis of Pancreatic Ductal Adenocarcinoma and Acute Pancreatitis: A Case-Control Study
No full textBackground and Objectives: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by a dense desmoplastic stroma with a poor prognosis. The aim of this study was to investigate whether resolvin (Rv) D1 could be used as a potential serum biomarker to discriminate between PDAC and acute pancreatitis (AP). Materials and Methods: In total, 67 patients were enrolled in the present study, including 21 patients with resectable PDAC, 23 patients with metastatic PDAC, 23 patients with AP, and a control group of 21 healthy individuals. RvD1 levels of PDAC patients were also analyzed through ELISA at the 6th postoperative month. Results: The mean RvD1 was 1169.24 ± 285.99 in the control group, 885.04 ± 134.25 in the AP group, 728.57 ± 140.1 in the PDAC group, and 670.09 ± 105.6 in the metastatic pancreatic cancer (PC) group. RvD1 was significantly lower in PDAC and metastatic PC groups compared to controls and patients with AP, while it was significantly lower in patients with AP compared to the control groups. Postoperative RvD1 levels of patients with PDAC were significantly higher than preoperative levels (728.57 ± 140.1 vs. 885.43 ± 275.57). In the ROC analysis, when the cut-off value for serum RvD1 level was 825 ng/L, it was found to predict PDAC from metastatic PC with 84.1% sensitivity and 81.8% specificity. Conclusions: Serum RvD1 is a new biomarker for the detection of PDAC. Serum RvD1 may provide an important diagnostic contribution in clinical practice to predict PDAC. Serum RvD1 levels were found to be predictive with high sensitivity and specificity in differentiating PDAC from metastatic PC. However, it was concluded that serum RvD1 levels cannot be used as a detection marker to differentiate PDAC from AP. RvD1 could be a representative agent of a new class of drugs to be proposed for innovative treatment of AP and PDAC. Our future study will investigate whether RvD1 can be a marker to differentiate from chronic pancreatitis
The Role of Patient-reported Outcomes and Medication Adherence Assessment in Patient-focused Drug Development for Solid Organ Transplantation
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