Diagnostic performance of elastography in cytologically indeterminate thyroid nodules.

Cytological examination of material from fine-needle aspiration biopsy is the mainstay of diagnosis of thyroid nodules, thanks to its remarkable accuracy and scarcity of complications. However, follicular lesions (also called indeterminate lesions or Thy3 in the current classification), a heterogeneous group of lesions in which cytology is unable to give a definitive diagnosis to, represent its main limit. Elastography has been proposed as a potential diagnostic tool to define the risk of malignancy in the aforementioned nodules, but at present there is no conclusive data due to the small number of specifically addressed studies and the lack of concordance among them.

Bisegmentectomies as alternative to right hepatectomy in the treatment of colorectal liver metastases.

Background/aims: Liver surgery for colorectal metastases has moved toward parenchymal sparing strategy with an increasing number of conservative resections. The aim of this study was to elucidate outcomes of bisegmentectomies for right liver metastases.

Methodology: The study focuses on 56 patients affected by liver metastases in the right liver with a diameter < or =10 cm undergoing anatomic resections of two or more segments.

Prognostic significance of lymph node metastases in pancreatic head cancer treated with extended lymphadenectomy: not just a matter of numbers.

Background: The prognostic significance of variables related to nodal involvement (node status, number of disease-positive nodes [posNn], node ratio [Nr], and site of nodal metastases) in patients with resected pancreatic head cancer remains poorly defined.

Methods: Clinical, operative, and pathologic data, including indexes of the burden and extent of nodal involvement, were analyzed in a consecutive series of 77 patients who underwent resection with extended lymphadenectomy for adenocarcinoma of the pancreatic head.

Results: Fifty-nine patients (77%) were found to have lymph node (LN) metastases.

Preoperative biliary drainage increases infectious complications after hepatectomy for proximal bile duct tumor obstruction.

Background: The role of preoperative biliary drainage before liver resection in jaundiced patients remains controversial. The objective of this study is to compare the perioperative outcome of liver resection for carcinoma involving the proximal bile duct in jaundiced patients with and without preoperative biliary drainage.

Methods: Seventy-four consecutive jaundiced patients underwent hepatectomy for carcinoma involving the proximal bile duct from January 1989 to June 2006 and their data were retrospectively analyzed.

Safety of conservative management of bile leakage after hepatectomy with biliary reconstruction.

Background: The risks associated with the conservative management of bile leakage after hepatectomy and associated cholangiojejunostomy are not well defined.

Aim: The aim of this study was to evaluate incidence and severity of complications associated with bile leakages after liver resection with biliary reconstruction.

Patients And Methods: Clinical data from 1,034 consecutive patients who underwent liver resection were prospectively collected and reviewed.

Bile leak after hepatectomy: predictive factors of spontaneous healing.

Background: Bile leakage after hepatectomy usually has spontaneous healing, but some patients require interventional procedures. To identify early predictive factors of conservative management failure.

Methods: This study focused on patients with bile leak after hepatectomy without extrahepatic biliary resection from 1996 through 2006.

Right hepatectomy with anterior approach for ruptured liver cell adenoma.

We report a case of a 37-year-old woman who was referred to a peripheral hospital with severe abdominal pain, vomiting and hemorrhagic shock. Ultrasonography and CT scan showed a large ruptured adenoma of the right liver. Because of hemodynamic instability, she underwent laparotomy with gauze packing and then she was referred to our department with a bleeding persisting at a rate of about 100 mL per hour from the abdominal drain.

Pancreatic resections after chemoradiotherapy for locally advanced ductal adenocarcinoma: analysis of perioperative outcome and survival.

Background: The most accepted treatment for locally advanced pancreatic cancer is chemoradiotherapy. However, indications to and results of pancreatic resections after chemoradiation are not yet defined.

Methods: From June 1999 to December 2003, 28 patients with locally advanced pancreatic cancer (group 1) were enrolled for institutional trials of gemcitabine-based chemoradiotherapy.

Bile leakage and liver resection: Where is the risk?

Hypothesis: The knowledge of risk factors for bile leakage after liver resection could reduce its incidence.

Design: Retrospective study.

Setting: Tertiary care referral center.