Wrapping in pancreatic surgery: a systematic review.

Background: Wrapping in pancreatic surgery involves the use of the omentum or falciform ligament (FL) to wrap the local retroperitoneal vessels, the pancreatojejunal anastomosis or the pancreatic section of distal pancreatectomy. However, there is no clear evidence that wrapping in fact provides benefits. We have performed a systematic review of the literature about this topic.

Is radical surgery feasible in liver hydatid cysts in contact with the inferior vena cava?

Background: Cysts in contact with the inferior vena cava (IVC) represent a challenge for hepato-pancreatico-biliary surgeons. Although the literature on the topic is scarce, the most widely accepted approach is conservative surgery. Partial cyst resection is recommended, because radical resection is considered a high-risk procedure.

Frank intrabiliary rupture in liver hydatidosis located in the hilar plate: a surgical challenge.

Background: Frank intrabiliary rupture (FIR) is a severe complication that occurs in around 30% of patients with liver hydatidosis. When FIR is present, the contents of the cyst may pass into the common bile duct and cause a variety of complications. If the FIR is located in the hilar confluence, surgical repair is a challenge.

[Gastroenteric reconstruction route after pancreaticoduodenectomy: antecolic versus retrocolic].

Introduction: Delayed gastric emptying (DGE) is a relatively common complication after cephalic pancreaticoduodenectomy (CPD). Its origin is not very clear, and it is believed that its appearance is due to multiple factors (hormones, appearance of other complications, particularly pancreatic fistulas, and the surgical technique). Among the technical aspects associated with DGE, it has been proposed that the route of gastroenteric reconstruction (antecolic or retrocolic) could have an effect on its incidence.

Liver metastasis of endometrial stromal sarcoma.

Resection of liver metastases from gynaecological tumours is uncommon. Endometrial stromal sarcomas (ESS) are low incidence gynecological tumours which can originate in previous sites of endometriosis or following metaplasia of the pelvic peritoneal wall, and which are exceptionally associated with liver metastasis. We present a 68-year-old woman with a ESS and metachronic liver metastasis treated by liver resection.

[Surgical treatment of melanoma liver metastases].

The appearance of liver metastases during the follow-up of a patient with a skin melanoma has classically been considered a sign of a very poor prognosis. There are limited therapeutic options, since these lesions are non-resectable and form part of a disseminated disease in several organs. In certain cases, in those where the disease is restricted to the liver or accompanied by a resectable extra-hepatic disease, hepatectomy can be useful, obtaining acceptable survivals of about 25% at 5 years, although hepatic or skin recurrence is usually early.

[Resection of liver metastases in patients with extrahepatic disease].

Patients who have liver metastasis and extrahepatic metastatic disease (EMD) have been considered as a patient subgroup with a very poor prognosis. Therefore, the presence of EMD was traditionally considered a contraindication for liver resection. But, survivals of around 30% at 5 years, and higher than that achieved with chemotherapy only obtained in some patients with liver metastasis of colorectal origin and EMD who had a resection performed on the hepatic and extrahepatic disease, obliges us to re-think what we must do in these patients.

Walled-off pancreatic necrosis.

Acute severe pancreatitits may be complicated by the development of 'walled-off pancreatic necrosis' (WOPN), which is characterised by a mixture of solid components and fluids on imaging studies as a consequence of organised pancreatic tissue necrosis. We present here an overview of the definition, clinical features, and diagnostic and therapeutic management of this clinical condition, which is mostly based on consensus as adequate clinical trials are lacking.

Cysto-biliary communication in liver hydatidosis.

Background: Liver hydatidosis is a severe health problem in endemic areas. Due to migration from these countries to other zones, now it is a worldwide problem. Liver hydatidosis can provoke many complications (abscess, fistula to adjacent organs, migration, etc.

Ambispective comparative study of two surgical strategies for liver hydatidosis.

Aim: To investigate the morbidity, mortality, recurrence and technical aspects of two distinct surgical strategies that were implemented in successive periods.

Methods: Ninty-two patients with 113 cysts underwent surgical procedures. The study was divided into 2 periods.

Extremely high values of CA 19-9 in liver hydatidosis and frank biliary rupture.

Elevation of carbohydrate antigen 19-9 has been observed in jaundiced patients with benign biliary tract diseases. No clear answer has explained that relationship. Patients with liver hydatidosis and frank intrabiliary rupture could present obstructive jaundice due to the presence of liver cyst material in the bile duct.

Retroperitoneal abscess due to dropped gallstones after laparoscopic cholecystectomy.

Complications of dropped gallstones after laparoscopic cholecystectomy are infrequent but retroperitoneal abscess is extremely rare. We present a new case, discuss causes, diagnostic methods, preventive measures and therapeutical options.

Hidatidosis of the spleen.

Unlabelled: Hydatidosis of the spleen (SH) is an extremally rare condition. The aim of the study was to present our experience and discuss diagnostic methods and therapeutical options in cases of spleen hydatidosis.

Material And Methods: Between 1993 and 2008, 8 patients were diagnosed with SH, 6 of whom were operated on (4 males and 2 females).

Three trocars laparoscopic resection of angiomyolipoma of the liver.

Angiomyolipoma of the liver (AML) is an infrequent neoplasm composed of three tissues (adipose, muscle and vessels). In spite of advances in radiology, preoperative correct diagnosis is difficult. Clasically, a conservative management strategy was adopted in patients with asymptomatic tumors less than 5 cm with undoubtful diagnosis.

Profile of patients with hepatic hydatid disease not treated surgically.

Background: hepatic hydatid disease (HHD) is still an important health problem in certain areas of Spain where it is endemic. The treatment of HHD is usually surgical but certain patients are found to be ineligible after assessment for surgery (asymptomatic disease, comorbidity, patient refusal, or other).

Material And Methods: description of patients assessed in the Department of Surgery for hepatic hydatid disease.

[Benign non-parasitic hepatic cystic tumours].

Hepatic cystic tumours are a heterogeneous group of diseases with different aetiology and incidence, and with similar clinical signs and symptoms. They are classified as congenital, traumatic, parasitic, or neoplastic cysts. The congenital cystic tumours are the most prevalent, and include the simple cyst and polycystic hepatic disease.