Bile leaks after videolaparoscopic cholecystectomy: duct of Luschka. Endoscopic treatment in a single centre and brief literature review on current management.

Background: Laparoscopic cholecystectomy (LC) for gallstone disease is the most common surgical procedures performed in Western countries and bile leaks remain a significant cause of morbidity (0.2-2%). The bile ducts of Luschka (DL)are small ducts which originate from the right hepatic lobe, course along the gallbladder bed, and usually drain in the extrahepatic bile ducts.

A Strange Case of Left Bowel Ischemia after Right Hernioplasty.

We report the first observed case of a young man who suffered of large and unsuspected left bowel ischemia following an elective right open hernioplasty. A 54-year-old man had a 2-year history of right inguinal reducible mass and was admitted to hospital for an elective day case open inguinal hernioplasty for a direct right inguinal hernia. Apart from mild hypertension controlled with ACE inhibitor, he was medically fit and well.

Duodenal Signet Ring Cell Carcinoma in a Celiac Patient.

Celiac disease results from damage to the small intestinal mucosa due to an inappropriate immune response to a cereal protein. Long-standing or 'refractory' celiac disease is associated with an increased risk of autoimmunity and malignancy. We produced a brief literature review starting from a case of duodenal cancer in a celiac patient.

Permanent stenting in "unextractable" common bile duct stones in high risk patients. A prospective randomized study comparing two different stents.

Background: Endoscopic sphincterotomy (ES) and stone extraction is the treatment of choice for bile duct stones. Therefore, if ES and conventional stone extraction fail, further treatment is mandatory. Insertion of a biliary endoprosthesis is an effective option.

Secondary aortoduodenal fistula.

Aorto-duodenal fistulae (ADF) are the most frequent aorto-enteric fistulae (80%), presenting with upper gastrointestinal bleeding. We report the first case of a man with a secondary aorto-duodenal fistula presenting with a history of persistent occlusive syndrome. A 59-year old man who underwent an aortic-bi-femoral bypass 5 years ago, presented with dyspepsia and biliary vomiting.

[Complication of flexible fiberoptic bronchoscopy. Literature review].

Introduction: Fiberoptic bronchoscopy is the gold standard to study and eventually treat tracheo-bronchial pathology. Performance of fiberoptic bronchoscopy enhances diagnostic precision and has not well documentated risks for the patients. This review examines the international literature of the last 30 yrs about the indication, complications and their prevention during bronchoscopy.

[Endoscopic treatment of a "gastric outlet syndrome" after Mason Vertical Banded Gastroplasty. Case report].

Introduction: Mason's Vertical Banded Gastroplasty (VBG) is characterized by peculiar complications, related to surgical pitfalls, from "outlet syndrome" (5%) to complete outlet obstruction (3%), passing to reflux oesophagitis (45%), that require redo. We report a case of "outlet syndrome" treated by operative endoscopy with success.

Materials And Methods: 40 yrs male, operated by VBG 2 years ago for morbid obesity (BMI > 40).

[Emergency thyroidectomy for primitive lymphoma of thyroid. Case report and diagnostic and therapeutic guidelines].

Objective: A case of acute wheezing causing primitive thyroid lymphoma observed ay the Operative Unit of General and Thoracic Surgery of the University "P Giaccone" of Palermo, Italy, is reported.

Experimental Design: Diagnostic, clinical and prognostic indication, evaluation of effectveness of radical surgical treatment and follow-up.

Intervention: Emergency radical surgical treatment (debulking) and surgical tracheostomy (tracheal infiltration).

[Mesenteric cyst lymphangioma; a case report and literature review].

Objective: The Authors report their experience in diagnosis and treatment of one case of mesenteric cystic lymphangioma; recent international literature review.

Experimental Design: Complete clinical report. Diagnostic, clinical and prognostic indication, evaluation of effectiveness of radical surgical treatment and follow-up.

[Complications in thyroid surgery: symptomatic post-operative hypoparathyroidism incidence, surgical technique, and treatment].

Introduction: Total thyroidectomy has a definite role in the management of malignant and benign thyroid disorders, with minimal complications and rare postoperative mortality. Even though thyroid surgery is quite safe, mechanical damage, devascularization or inadvertent removal of the parathyroid glands are possible. The aim of this study is to report report the personal surgical experience and to define some of the pathologic and clinical characteristics of unintentional parathyroidectomy and post-thyroidectomy hypocalcemia.

[Infrequent early complication of mechanical digestive anastomosis: bleeding. Personal experience].

Introduction: Bleeding from mechanical digestive anastomosis is an uncommon complication (0.9-3.2%) often self-limiting but potentially lethal if not evidenced intraoperatively or in the immediate postoperative.

Trocar-related abdominal wall bleeding in 200 patients after laparoscopic cholecistectomy: Personal experience.

Aim: To determine the complications and incidence of the first and second access-related vascular injuries induced by videolaparoscopic cholecistectomy.

Methods: We retrospectively reviewed vascular injuries in 200 consecutive patients who underwent videolaparoscopic cholecistectomy from 2003 to 2005. One hundred and one patients with placement of radial expanding trocars were assigned into group A and 99 patients with placement of pyramidal tipped trocars into group B.

Presence of white bile in malignant biliary obstruction is associated with poor prognosis: personal preliminary observations.

Objective: The chemical composition and clinical significance of white bile in patients with malignant obstructive jaundice were evaluated in a prospective study.

Materials And Methods: 115 consecutive patients with inoperable malignant biliary obstruction underwent endoscopic placement of 10 Fr straight, plastic biliary stents, Amsterdam-type. Bile was aspirated during the endoscopic procedure and a blood sample was taken.

[Biliary stent placement for postoperative benign bile duct stenosis: personal experience].

Objective: To describe the management and outcome after endoscopic treatment of 23 patients with post-operative benign bile duct stricture (BBDS) managed in Authors' Department from 1991 to 2000.

Background Data: The management of the postoperative bile duct strictures remains a challenge for even the most skilled biliary tract surgeon and endoscopist. The 1990s saw a dramatic increase in the incidence of bile duct strictures from the introduction and widespread use of laparoscopic cholecystectomy.

[Substernal goitre. Personal experience].

Introduction: Aim of the study is to discuss the diagnostic and therapeutic problems of substernal goiter (SG).

Materials And Methods: The Authors retrospectively analyzed 12 patients (3.1%) with substernal goiters among 379 patients undergoing surgical treatment for thyroid diseases from January 2000 to 2005, and evaluated the clinical data, preoperative diagnostic findings, surgical treatments, histopathological results, and postoperative complications.

[Endoscopic palliation of obstructive jaundice caused by inoperable pancreatic cancer: personal experience].

Aim Of The Study: Few patients with pancreatic cancer are eligible for resection. In the remainder, estimation of prognosis is important to optimise various aspects of care, including palliation of biliary obstruction and trial of chemotherapy. The aim is to refer our personal experience about the palliation with endoscopic stenting in patients with unresectable pancreatic cancer.

[Treatment of gastrointestinal stromal tumor (GIST)--review of the literature and a case report].

Background: Gastrointestinal stromal tumors (GIST) are rare mesenchimal tumors that are characterized by constitutive overexpression of the tyrosin-kinase receptor KIT (CD117). The authors analyse the basis of the treatment of gastric GIS, starting form the study of a recent observed case.

Experimental Design: Report of one case treated with endoscopic resection.

[Videolaparoscopic cholecystectomy: personal experience].

Aim: Laparoscopic cholecystecomy (LC) is now the gold standard for the treatment of gallstones. In this report were analyzed 153 LC performed by a single surgical team and, according to results, elaborated any technical recommendation.

Materials And Methods: 153 LC has been performed in Section of General and Thoracic Surgery of University of Palermo, Sicily, by a single surgical team, since 2000.

[Bronchial carcinoid: a review of the recent literature].

Objective: To evaluate methods of diagnosis and treatment, and the long term survival of patients treated for bronchial carcinoid tumor by the review of recent literature.

Methods: The Authors conducted a retrospective study on internet-based-evidence of patients treated for bronchial carcinoid tumor since 1993 to 2004. Symptoms, diagnosis, operative approach and survival were assessed.

[A rare complication of ERCP: Mallory-Weiss syndrome].

Objective: To describe the management and outcome after endoscopic treatment of hematemesis by Mallory-Weiss Syndrome (MWS) occurred after CPRE (suspected choledocolithiasis).

Background Data: Although cough and retching is common during EGD or CPRE, MWS resulting from endoscopy seems to be uncommon (0.0001-0.

[Surgical treatment of liver hydatidosis: our experience with diagnostic and therapeutic consideration].

Objective: The Authors report on their experience in diagnosis and treatment of liver hydatidosis (LH).

Materials And Methods: From January 2000 to December 2003, we observed 24 patients (10 male = 42% and 14 female = 58%, male/female ratio 1:1.4, range of age 23 - 80 years, mean age 45.

[Prevention of clogging of biliary stents by administration of levofloxacin and ursodeoxycholic acid].

One of the main advances in biliopancreatic endoscopic therapy has been the ability to palliate patients with biliary obstruction by placement of a stent during ERCP, but this is often complicated by clogging of the stent with subsequent jaundice and/or cholangitis. Stent clogging may be caused by microbiological adhesion and biliary stasis. Therefore, the use of antibiotics and choleretic agents such as levofloxacin and ursodeoxycholic acid has been investigated to see whether they prolong stent patency.