Therapeutic options for body packers: surgical or conservative treatment? A single center experience and review of literature.

Unlabelled: Body packing is a way to deliver packages of drugs hidden in body cavities. In Europe, as noted the latest report coming from the Brussels observatory, there are 74 million drugs consumers. Italy is in pole position and Perugia was considered as a "capital city" in the drug market.

Distal pancreatectomy with splenic preservation: A short-term outcome analysis of the Warshaw technique.

Introduction: Spleen-preserving left pancreatectomy (SPDP) with splenic vessels preservation (SVP) or without (Warshaw technique, WT) has been described with robotic, laparoscopy and open surgery. Nevertheless, significant data on medium- and long-term follow-up are still not available, since data in literature are scarce and the level of evidence is low.

Methods: In this retrospective study, we describe and compare short and medium term results of spleen-preserving distal pancreatectomy in eight patients.

Can the measurement of amylase in drain after distal pancreatectomy predict post-operative pancreatic fistula?

Introduction: The most frequent reason for performing a distal pancreatectomy is the presence of cystic or neuroendocrine tumors, in which the distal pancreatic stump is often soft and non fibrotic. This parenchymal consistence represents the main risk factor for post-operative pancreatic fistula. In order to identify the fistula and assessing its severity postoperative monitoring of amylase from intraperitoneal drains is important.

Autoimmune pancreatitis: a case of difficult diagnosis.

Autoimmune pancreatitis (AIP) is an insidious disease of non-specific symptomatology. To make correct diagnosis three different findings must correlate: radiological imaging, serological markers, and histology. This is not easy, and furthermore an incorrect diagnosis can lead to incorrect management and even patient death.

Road accident due to a pancreatic insulinoma: a case report.

Insulinoma is a rare pancreatic endocrine tumor, typically sporadic and solitary. Although the Whipple triad, consisting of hypoglycemia, neuroglycopenic symptoms, and symptoms relief with glucose administration, is often present, the diagnosis may be challenging when symptoms are less typical. We report a case of road accident due to an episode of loss of consciousness in a patient with pancreatic insulinoma.

Robotic rectal resection for cancer: a prospective cohort study to analyze surgical, clinical and oncological outcomes.

Aim: Robotic systems are getting widely spread in recent years given the different technical advantages over traditional laparoscopy. Rectal surgery seems to benefit from this approach, for its ability to easily work in a confined space such as the pelvic cavity. The objective is to present results obtained by the robotic approach in patients with rectal cancer and to give technical considerations.

A rare nosological entity: the perforated solitary cecal diverticulum. Research article.

Aim: To describe three cases of solitary cecal diverticulum, and trying to evaluate the better method of diagnosis and treatment with analysis of the literature.

Material Of Study: Description of three cases of solitary cecal diverticulum's perforation admitted in the Department of General and Oncologic Surgery, Santa Maria della Misericordia Hospital, Perugia, during the period January 2011 - January 2012.

Results: In all patients the clinical presentation was very similar to that of acute appendicitis.

The surface landmarks of the abdominal wall: a plea for standardization.

Despite centuries of anatomical studies, controversies and contradictions still exist in the literature regarding the definition, anatomical terminology and the limits of the abdominal wall. We conducted a systematic research of books published from 1901 until December 2012 in Google Books. After the index screening, 16 remaining books were further assessed for eligibility.

Laparoscopic versus open left colectomy in patients with sigmoid colon cancer: prospective cohort study with long-term follow-up.

Background: Laparoscopic left colectomy has obtained a large spread in colon surgery for malignant disease despite the need for an adequate learning curve. However few studies reported long term data in comparison with open left colectomy and most of the authors of large series on colorectal surgery don't describe, in subgroup analysis, results obtained in left colonic resections. The aim of this study is to report the short and long term follow-up of laparoscopic left colon resection in comparison with the open approach, from a single centre, performed in the same timeframe.

Incidental finding of carcinoid tumor on Meckel's diverticulum: case report and literature review, should prophylactic resection be recommended?

Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and is caused by incomplete obliteration of the vitelline duct during intrauterine life. MD affects less than 2% of the population. In most cases, MD is asymptomatic and the estimated average complication risk of MD carriers, which is inversely proportional to age, ranges between 2% and 4%.

A rare case of perforated descending colon cancer complicated with a fistula and abscess of left iliopsoas and ipsilateral obturator muscle.

Perforation of descending colon cancer combined with iliopsoas abscess and fistula formation is a rare condition and has been reported few times. A 67-year-old man came to our first aid for an acute pain in the left iliac fossa, in the flank, and in the ipsilateral thigh. Ultrasonography and computed tomography revealed a left abdominal wall, retroperitoneal, and iliopsoas abscess that also involved the ipsilateral obturator muscle.

Case series of non-operative management vs. operative management of splenic injury after blunt trauma.

Background: The spleen is the most easily injured organ in abdominal trauma. The conservative, operative approach has been challenged by several reports of successful non-operative management aided by the power of modern diagnostic imaging. The aim of our retrospective study was to compare non-operative management with surgery for cases of splenic injury.

Right hemicolectomy plus pancreaticoduodenectomy vs partial duodenectomy in treatment of locally advanced right colon cancer invading pancreas and/or only duodenum.

Introduction: Pancreatic or duodenal invasion by locally advanced right colon cancer is an unusual event whose management still represents a surgical challenge. This review aims to compare results of limited vs. extended resection in case of primary right colon cancer invading pancreas and/or duodenum.

Requirement for a standardised definition of advanced gastric cancer.

Each year, ~988,000 new cases of stomach cancer are reported worldwide. Uniformity for the definition of advanced gastric cancer (AGC) is required to ensure the improved management of patients. Various classifications do actually exist for gastric cancer, but the classification determined by lesion depth is extremely important, as it has been shown to correlate with patient prognosis; for example, early gastric cancer (EGC) has a favourable prognosis when compared with AGC.

The integrated role of ultrasonography in the diagnosis of soft tissue metastases from melanoma: preliminary report of a single-center experience and literature review.

Currently melanoma has the fastest growing incidence of all cancers in men and the second in women (after lung cancer) in Western countries. Since prognosis of skin melanoma is excellent in early stages but dramatically worsens in advanced stages, an early diagnosis is fundamental in granting patients a favorable outcome. Sentinel node (SN) biopsy represents the gold standard for accurately staging melanoma, but other tests are commonly endorsed both in the initial staging work-up and in the follow-up, such as ultrasonography, computed tomography (CT)-scan and positron emission tomography (PET)-CT.

Current status of robotic bariatric surgery: a systematic review.

Background: Bariatric surgery is an effective treatment to obtain weight loss in severely obese patients. The feasibility and safety of bariatric robotic surgery is the topic of this review.

Methods: A search was performed on PubMed, Cochrane Central Register of Controlled Trials, BioMed Central, and Web of Science.

Is non-operative management safe and effective for all splenic blunt trauma? A systematic review.

Introduction: The goal of non-operative management (NOM) for blunt splenic trauma (BST) is to preserve the spleen. The advantages of NOM for minor splenic trauma have been extensively reported, whereas its value for the more severe splenic injuries is still debated. The aim of this systematic review was to evaluate the available published evidence on NOM in patients with splenic trauma and to compare it with the operative management (OM) in terms of mortality, morbidity and duration of hospital stay.

Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials.

Background: The evidence regarding the effectiveness and safety of laparoscopic sleeve gastrectomy (LSG) has been mostly based on the data derived from nonrandomized studies. The objective of this study was to evaluate the outcomes of LSG and to present an up-to-date review of the available evidence based on the recent publications of new randomized, controlled trials (RCTs).

Methods: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched until November 2012 for RCTs on LSG.

Effects of laparoscopic sleeve gastrectomy in patients with morbid obesity and metabolic disorders.

Purposes: Obesity and its correlation with other pathological conditions determine the onset of the metabolic syndrome, which exposes the patient to a higher risk of major cardiovascular complications. Laparoscopic sleeve gastrectomy (LSG) is a bariatric surgical procedure that appears to influence both the reduction of fat mass and the action of some gastrointestinal hormones.

Patients And Methods: Between January 2011 and July 2013, 23 patients with morbid obesity underwent LSG and follow-up.

Endoscopic rendez-vous after damage control surgery in treatment of retroperitoneal abscess from perforated duodenal diverticulum: a techinal note and literature review.

Introduction: The duodenum is the second seat of onset of diverticula after the colon. Duodenal diverticulosis is usually asymptomatic, but duodenal perforation with abscess may occur.

Case Presentation: Woman, 83 years old, emergency hospitalised for generalized abdominal pain.

Laparoscopic single-stapling gastric transection for exophytic pedunculated gastrointestinal stromal tumor: is a safe procedure?

Gastrointestinal stromal tumors (GISTs) represent the most common mesenchymal tumors of the gastrointestinal tract. The macroscopic growth of these lesions can be intraluminal, extraluminal, or intramural, but only 6 cases in literature report a description of the pedunculated type. A 69-year-old man was admitted to our department after an echocardiographical control revealing, as an incidental consequence, an epigastric mass.

Liver resection versus radiofrequency ablation in the treatment of cirrhotic patients with hepatocellular carcinoma.

Background: Hepatocellular carcinoma is the most common type of primary liver tumor and its incidence is increasing worldwide. The study aimed to compare patients subjected to liver resection or radiofrequency ablation.

Methods: One hundred and forty cirrhotic patients in stage A or B of Child-Pugh with single nodular or multinodular hepatocellular carcinoma were included in this retrospective study.

Oncologic reliability of nipple-sparing mastectomy for selected patients with breast cancer.

Background: Nipple sparing mastectomy (NSM) is the current surgical alternative to conventional techniques, when mastectomy is required. This less invasive procedure safeguards the integrity of the nipple areola complex (NAC), whose removal is recognized as a factor that exacerbates the patient's feeling of mutilation, however ensuring oncological radicality for women with breast cancer.

Patients And Methods: From January 2003 to January 2011, 77 patients underwent Nipple Sparing Mastectomy (NSM).