Does the Overall Survival of the Resectable Periampullary Carcinomas Correlate with High Expression of p53 and ki67?

Periampullary carcinomas represent a group of tumors that develop in a complex area, implying different anatomical structures. The most common histological type of periampullary carcinomas is the adenocarcinoma. The pancreatic type of periampullary adenocarcinomas has the worst prognosis.

Proposal of a Preoperative CT-Based Score to Predict the Risk of Clinically Relevant Pancreatic Fistula after Cephalic Pancreatoduodenectomy.

: Postoperative pancreatic fistula after cephalic pancreatoduodenectomy (CPD) is still the leading cause of postoperative morbidity, entailing long hospital stay and costs or even death. The aim of this study was to propose the use of morphologic parameters based on a preoperative multisequence computer tomography (CT) scan in predicting the clinically relevant postoperative pancreatic fistula (CRPF) and a risk score based on a multiple regression analysis. : For 78 consecutive patients with CPD, we measured the following parameters on the preoperative CT scans: the density of the pancreas on the unenhanced, arterial, portal and delayed phases; the unenhanced density of the liver; the caliber of the main pancreatic duct (MPD); the preoperatively estimated pancreatic remnant volume (ERPV) and the total pancreatic volume.

Laparoscopic Approach of Primary Hydatid Cyst of the Pancreas - Case Report and Literature Review.

The pancreatic localization of the hydatid cyst is exceptional, even in countries where hydatid disease is considered endemic. We describe a female patient, 63 years old, with hydatid cyst of the pancreas. The diagnosis was difficult because the presentation was that of an epigastric cyst of unknown origin, with no suggestive radiological and ultrasonography features.

Early Spontaneous Graft Intra- and Perihepatic Hematoma after Liver Transplantation.

Hematoma of the graft is a life threatening complication of liver transplantation (LT) and there has been no overt conclusion in the literature about optimal management except in scarcely reported cases. It may be either intrahepatic or subcapsular, then again it may develop spontaneously or following parenchimal injuries or transhepatic percutaneous invasive manoeuvers. In this report we describe a rare case of large spontaneous graft intra- and perihepatic hematoma.

LIVER METASTASIS OF A GASTROINTESTINAL STROMAL TUMOR OF LARGE BOWEL: CASE REPORT.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal malignancies of the digestive tract. We present the case of a 61-year-old male patient liver metastasis of a GIST with primary location at the level of sigmoid colon. Like in the majority of cases, the symptomatology in this patient has long been faint and when it became manifest, it was nonspecific.

Rare Tumors, Rare Association: Ovarian Strumal Carcinoid - Retroperitoneal Cystic Lymphangioma.

Introduction: Strumal carcinoid is a rare neoplasm of the ovary containing thyroid (struma) and carcinoid component revealed by immunohistochemistry. Case present: A 55-years-old woman with hysterectomy and right oophorectomy for uterine leiomyoma and right ovarian cyst, performed 12 years ago, was referred to the First Surgical Clinic, St. Spiridon University Hospital Iasi with pain in hypogastrium present for 2 months.

Retrosternal goiters.

Unlabelled: The term of retrosternal or substernal goiter means that more than 50% of thyroid gland descends in the thorax.

Material And Methods: There is a retrospective study on retrosternal and substernal goiter and its patological features among 2482 patients who underwent thyroidectomy between 2000 and 2010 in the First Surgery Clinic of Iaşi. Retrosternal goiter was identified 54 patients (2.

Laparoscopic approach to ovarian dermoid cysts.

Introduction: Ovarian dermoid cysts (mature cystic teratomas) are a benign type of germ cell tumours and the most common ovarian neoplasms in women of fertile age. The aim of this study was to analyze the safety of the laparoscopic approach in ovarian dermoid cysts.

Methods: We performed a prospective study between 2006 and ' 2010 including 38 mature cystic teratomas treated either laparoscopically or by open access.

[Right colon cancer--clinicopathological findings].

Background: The right colon cancer (RCC) has some particularities from point of view of epidemiology, clinical aspects, therapy and prognosis.

Material And Methods: We retrospectively analyzed the patients operated in the First Surgical Unit Iaşi during 2004 until 2009, for right colon cancer. The patients' data from the medical files were digitally encoded and included into a MS Access database, and statistically analyzed.

Multiple focal liver lesions - diagnosis challenges. Case report.

Multiple focal liver lesions can generate diagnosis difficulties in daily practice. This paper present the case of a 53 years old patient with multiple hyperechoic liver lesions suggestive for hepatic hemangiomas, detected during the ultrasonographic exam. Contrast enhanced ultrasonography indicated focal hepatic steatosis, while computed tomography proposed possible liver metastasis.

Palliative gastrectomy in patients with stage IV gastric cancer--our recent experience.

Background: Patients with metastatic gastric cancer are usually not good operative candidates. Recent improvements in surgical techniques allowed palliative gastric resection and other surgical procedures.

Method: We have examined the place of palliative gastrectomy and its impact on survival in stage IV gastric cancer patients admitted in 2003-2008 period.

Incomplete deployment of an expandable metallic stent in a patient with esophageal malignant stenosis.

The use of self expandable metallic stents (SEMS) in the palliation of dysphagia due to malignant esophageal stenosis is a gold standard. Covered stents are used in all cases with overt air-digestive fistula or high potential for fistula development. The procedure is associated with a low incidence of procedure-related complications.

[Heterotopic accessory pancreas in surgical pathology: review of 23 years experience].

Background: The abnormal presence of the pancreatic tissue in other digestive organs is rare but sometimes is the cause of some surgical diseases.

Material And Method: This retrospective study is focussed on heterotopic pancreas cases diagnosed in 2nd Surgical Clinic of "Sf. Spiridon" Emergency Hospital from Iaşi between Jan.

Acute appendicitis--open or minimally-invasive approach?

Background: Although laparoscopy has become the standard approach in other procedures, this technique is not generally accepted for acute appendicitis.

Aim: To evaluate the results after minimally invasive appendectomies.

Methods: All medical records of patients operated for acute appendicitis during the last year were retrospectively reviewed.

Small bowel malignant melanoma--report of three cases and review of literature.

Malignant melanomas have a predilection to metastasize to the small bowel. Three patients with malignant melanoma involving the small bowel are reported. Two patients were operated on for small bowel obstruction and the third for gastrointestinal bleeding with anemia.

[Surgical treatment of hyperparathyroidism].

Background: Hyperparathyroidism (HPT), the result of excessive secretion of the parathormone, is one of the most common endocrine disorders. In most forms of HPT, surgical parathyroidectomy is the best choice.

Aim: This paper aims to examine patients with hyperparathyroidism operated in First Surgical Unit Iaşi, in terms of indications, surgical technique and postoperative results.

[Present trends in abdominal actinomycosis].

Background: Actinomycosis is a chronic infectious disease caused by bacteria in the Actinomyces genus. The pathologic, clinic and imagistic polymorphism and the rare incidence of this disease make it so frequent misdiagnosed.

Material And Method: Single unit retrospective nonrandomized clinical study on over 40 years of experience in diagnosing and treating abdominal actinomycosis.

[Parathyroid glands involvement in multiple endocrine neoplasia].

Unlabelled: Multiple endocrine neoplasias are syndromes characterized by the involvement of at least two endocrine glands. Parathyroid gland involvement is usually noted in Multiple Endocrine Neoplasia (MEN) type I and type II. Parathyroid glands tumor associated with endocrine pancreatic tumor, as well as pituitary tumors is the typical pattern of MEN I.

[Surgical treatment of gynecomastia].

Background: Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, the surgical procedure is the treatment of choice. There are two main surgical procedures: subdermal mastectomy and liposuction.

Small Bowell Malignant Melanoma-Report of Three Cases and Review of Literature.

Malignant melanomas have a predilection to metastasize to the small bowel. Three patients with malignant melanoma involving the small bowel are reported. Two patients were operated on for small bowel obstruction and the third for gastrointestinal bleeding with anemia.

[Pyogenic liver abscesses].

Background: Pyogenic liver abscesses were a relative rare disease. In the last decades the management of the liver abscesses was changed due to the new imaging and surgical techniques.

Aim: To evaluate the clinical features, imaging techniques and treatment of the liver abscesses.

[Pancreaticoduodenectomy with or without pylorus preservation: a retrospective analysis of 137 patients].

Objective: We performed a retrospective study to assess the postoperative results, long-term survival and quality of life after pylorus preserving pancreaticoduodenectomy (PPPD) versus standard Whipple pancreaticoduodenectomy (WPD).

Methods: A retrospective study was performed in a nonselected series of 137 patients who were operated in the Surgical Clinics of "St. Spiridon" University Hospital Iaşi, Romania, from January 1st, 1995 till December 31, 2005.

[Torsion and infarction of an accessory liver lobe].

Anatomical abnormalities of the liver are extremely rare. We report a case of a 32 year old female who has admitted with acute epigastric pain and vomiting. Physical exam revealed a mobile mass in right middle abdominal quadrant.

[Pancreaticoduodenectomy for pancreatic head cancer, 54 cases].

Unlabelled: Pancreatic cancer has an increase rate in western countries. From the first pancreaticoduodenectomy (PD) performed by Kausch in 1909, the value of the resection in the treatment of pancreatic head cancer was disputed.

Aim: To assess the PD with or without pylorus preservation as surgical treatment for pancreatic cancer.

[Gastric stromal tumor. Case report].

Unlabelled: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastro intestinal tract and express the c-kit proto-oncogene protein (CD-117). We report herein a case of a 58 years old male with upper abdominal pain and anaemia. Preoperative endoscopic and barium meal exams showed a submucosal tumor in the gastric fornix.