One-stage approach to cholecystocholedocholithiasis treatment: a feasible surgical strategy for emergency settings and frail patients.

Background: Cholecystocholedocholithiasis (CCL) occurs in up to 18% of patients undergoing laparoscopic cholecystectomy (LC). The two-stage treatment using endoscopic retrograde cholangiopancreatography (ERCP) followed by LC is the treatment of choice for CCL. However, only 10 to 60% of patients have common bile duct (CBD) stones at the time of ERCP, thus exposing patients to unnecessary ERCPs, causing 3 to 15% of post-interventional pancreatitis.

Laparoscopic lavage and drainage for Hinchey III diverticulitis: review of technical aspects.

The surgical treatment for patients with generalized peritonitis complicating sigmoid diverticulitis is currently debated; particularly in case of diffuse purulent contamination (Hinchey 3). Laparoscopic lavage and drainage (LLD) has been proposed by some authors as a safe and effective alternative to single- or multi-stage resective surgery. However, among all the different studies on LLD, there is no uniformity in terms of surgical technique adopted and data show significant differences in postoperative outcomes.

Formation of Sulforaphane and Iberin Products from Thai Cabbage Fermented by Myrosinase-Positive Bacteria.

Myrosinase-positive bacteria from local fermented foods and beverages in Thailand with the capacity to metabolize glucosinolate and produce isothiocyanates (ITCs) were isolated and used as selected strains for Thai cabbage fermentation. 4A-2A3.1 (EX) from fermented fish and SB2X2 (EC) from fermented cabbage were the two highest ITC producers among seventeen strains identified by 16S rRNA technique.

Day case laparoscopic cholecystectomy: Safety and feasibility in obese patients.

Introduction: Day-case laparoscopic cholecystectomy (DCLC) is not universally adopted and its use is limited to patients selected by non-standardized criteria. Since laparoscopic cholecystectomy is considered technically more difficult in obese patients, a high body mass index (BMI) is often considered an exclusion criterion for DCLC. The aim of this research is to define the feasibility and safety of day case laparoscopic cholecystectomy in obese patients.

Emergency Hartmann's Procedure and Its Reversal: A Totally Laparoscopic 2-Step Surgery for the Treatment of Hinchey III and IV Diverticulitis.

Background: Hartmann's procedure (HP) followed by reversal restoration is the first choice for treatment of diffuse diverticular peritonitis. There is no unanimous consensus regarding the use of laparoscopy to treat the same condition.

Methods: Data from 60 patients with diverticular diffuse peritonitis who underwent urgent HP followed by laparoscopic reversal were retrospectively analyzed.

Impact of radiofrequency energy on intraoperative outcomes of laparoscopic colectomy for cancer in obese patients.

Nowadays laparoscopic approach is accepted as a valid alternative to open surgery for the treatment of colorectal cancer. Several studies consider this approach to be safe and feasible also in obese patients, even if dissection in these patients may require a longer operative time and involve higher blood loss. To facilitate laparoscopic approach, more difficult in these patients, several energy sources for laparoscopic dissection and sealing, has been adopted recently.

Ultrasound-Guided Placement of Central Venous Port Systems via the Right Internal Jugular Vein: Are Chest X-Ray and/or Fluoroscopy Needed to Confirm the Correct Placement of the Device?

Background: Percutaneous central venous port (CVP) placement using ultrasound-guidance (USG) via right internal jugular vein is described as a safe and effective procedure. The aim of this study is to determine whether intraoperative fluoroscopy (IF) and/or postoperative chest X-ray (CXR) are required to confirm the correct position of the catheter.

Methods: Between January 2012 and December 2014, 302 adult patients underwent elective CVP system placement under USG.

Treatment of congenital liver cysts. A surgical technique tailored through a 35-year experience.

Background: The most important aims of the treatment of CLC are long-term relief of symptoms and elimination of cysts. Treatment of choice is yet debated.

Methods: Data of patients treated for CLC during a 35-years experience were retrospectively analyzed.

Desmoplastic fibroblastoma of the thigh. A case report.

Desmoplastic fibroblastoma (DF) is an extremely rare benign soft tissue tumor, prevalent in adult men, mostly arising in deep regions of extremities. The tumor presents with a slowly growing and no recurrence or metastases after surgical excision. Histologically, DF is characterized by a collagenous stroma that contains spindle- and stellated-shaped fibroblastic cells positive for vimentin.

Anastomotic leakage and septic complications: impact on local recurrence in surgery of low rectal cancer.

Purpose: We thought to determine the influence of anastomotic leakages (AL) and septic complications (SC) on the incidence of local recurrence (LR) in patients undergoing curative surgery for rectal cancer.

Methods: The records of 479 patients (286 male, 193 female; median age 67 years) who received, between 1966 and 1975 (Group A) and 1976 and 1985 (Group B), curative surgery for middle to low rectal cancer were retrospectively reviewed. All patients received mesorectal excision in the course of abdominoperineal excision (Group A) and of anterior resection with colorectal anastomosis (Group B).

Urgent surgery for sigmoid diverticulitis. Retrospective study of 118 patients.

Objective: Aim of our study was to identij5 the risk factors for operative morbility and mortality after urgent surgery for complicated sigmoid diverticulitis. A further end point was define the adequate surgical approach in these patients.

Methods: Data fJom 118 patients who were admitted for emergency surgery between 2000 and 2009 for non-haemorrhagic complicated diverticulitis of the sigmoid colon were retrospectively evaluated and analysed.

Metastasis to the Pancreas from Breast Cancer: Difficulties in Diagnosis and Controversies in Treatment.

BACKGROUND: Metastasis to the pancreas originating from malignant tumours is a rare event and, in the literature, we have found only 11 reported cases of solitary pancreatic metastases originating from breast cancer. CASE REPORT: We report a case of a 51-year-old woman with primary breast cancer who developed obstructive jaundice and epigastric pain after 2 years without any symptoms. The pancreatic mass revealed by computed tomography (CT) scan and magnetic resonance imaging (MRI) was not recognised as a metastasis from breast cancer and the patient underwent cephalic pancreaticoduodenectomy.

Ghost ileostomy: real and potential advantages.

Loop ileostomy is created to minimize the clinical impact of colorectal anastomotic leak. However, a lot of complications may be associated with ileostomy presence and with its reversal. Moreover, patients hardly accept the quality of life resulting from ileostomy.

Surgical treatment of hydatid disease of the liver: 25 years of experience.

Background: The aim of this study was to evaluate the results of conservative and radical treatment of liver hydatid disease.

Methods: Records of patients who underwent surgery for liver hydatid disease between 1980 and 2005 were reviewed. Outcomes measured were operative morbidity and mortality, hospital stay, and recurrence.

Indications and results for transduodenal sphincteroplasty in the era of endoscopic sphincterotomy.

Background: Transduodenal sphincterotomy (TS) has fallen into disuse since endoscopists developed techniques to treat sphincter problems nonsurgically. However, some patients experience recurrent sphincter strictures after endoscopic sphincterotomy (ES), with the ampulla endoscopically inaccessible, and pancreas divisum (PD); these patients are referred to a surgeon because they are unsuitable for ES.

Methods: The medical records of patients who underwent TS at the First Department of Surgery of the Medical School, University of Rome "La Sapienza," between January 1997 and December 2005 were reviewed.

Intra-operative ultrasound for detection of liver metastases from colorectal cancer.

Objective: The aim of this study was to evaluate the accuracy of intra-operative ultrasound (IOUS) imaging in detecting liver secondaries at the time of primary colorectal surgery and to evaluate the impact of IOUS on patient management.

Methods: Data from 167 patients with primary colorectal cancer who were admitted for elective surgery between January 1995 and December 2003 were prospectively evaluated and analysed. All patients underwent pre-operative abdominal ultrasonography (US) and computed tomography (CT), as well as IOUS.