Management of Bile Duct Injuries: A 6-year Experience in a High Volume Referral Center.

Objectives: The aim of our study was to determine operative and nonoperative treatments performed in bile duct injuries and the effect of a multidisciplinary approach on the treatment.

Background: Bile duct injuries may lead to morbidities such as biliary leakage, peritonitis, and mortality.

Materials And Methods: A total of 83 patients with biliary complications (37 patients with iatrogenic bile duct injury referred to our clinic from other centers were also included in this study) were evaluated.

Efficacy of Thiol Disulfide Homeostasis and Ischemia Modified Albumin Values in Estimating the Degree of Difficulty for Laparoscopic Cholecystectomy.

Aim: The aim of this study was to investigate the efficacy of thiol disulfide homeostasis and Ischemia Modified Albumin (IMA) values in predicting the technical difficulties that might be encountered during laparoscopic cholecystectomy.

Materials And Methods: The study included 65 patients who underwent laparoscopic cholecystectomy due to cholelithiasis at the General Surgery Clinic of Ankara Numune Training and Research Hospital. All patients' demographic data, previous history of cholecystitis, a history of chronic illness, preoperative white blood count (WBC), liver function tests (AST, ALT), amylase and lipase levels, intra-operative adhesion score, the ultrasonographic appearance of gall bladder, duration of hospital stay, duration of operation, thiol disulfide and IMA values were evaluated.

Artificial neural network analysis for evaluating cancer risk in multinodular goiter.

Background: The aim of this study was to create a diagnostic model using the artificial neural networks (ANNs) to predict malignancy in multinodular goiter patients with an indeterminate cytology.

Materials And Methods: Out of 623 patients, 411 evaluated for multinodular goiter between July 2004 and March 2010 had a fine-needle aspiration biopsy. All patients underwent total thyroidectomy.

Serum chitotriosidase activity in acute appendicitis: preliminary results.

Chitotriosidase is one of the most quantitative proteins secreted by activated macrophages, so its activity has been proposed as a biochemical marker of macrophage accumulation. The clinical importance of the chitotriosidase is still largely unknown. Our aim was to evaluate diagnostic accuracy of serum chitotriosidase activity in acute appendicitis (AA).

Peritoneal hydatidosis with ileus.

Background: The parasitic infection hydatidosis or echinococcosis, is a parasitic infection caused most frequently by flatworm Echinococcus granulosus. Hydatidosis is endemic in Turkey where animal husbandry is common. Eventhough, Hydatid disease can develop anywhere in the human body it is most frequently occurs in the liver and then the lungs.

Receiver operating characteristic analysis of leukocyte counts in operations for suspected appendicitis.

Study Objective: There has been no clear-cut value of the white blood cell (WBC) count in differential diagnosis of acute appendicitis in emergency medicine. Therefore, the aim of this study was to assess the preoperative WBC counts in 3 groups of patients operated on for a clinical suspicion of acute appendicitis with different findings at appendectomy: uninflamed appendix, uncomplicated acute appendicitis, or complicated acute appendicitis.

Methods: The medical records of 540 patients who underwent appendectomy for suspected acute appendicitis during a 17-month period were retrospectively reviewed.

Primary echinococcal cyst of the thyroid: report of a case.

A case of primary hydatid disease of the thyroid, a rare location, is presented. The patient was a 50-year-old woman who presented with a neck mass at the thyroid region, which was noticed 2 months before her presentation. Although the clinical impression was of a neoplastic lesion (adenoma or carcinoma), a hydatid cyst was considered intraoperatively and confirmed by a frozen section histology.

Bilateral ductal carcinoma in situ of the breast after radiation therapy for Ewing's sarcoma of the vertebra in a young woman: report of a case.

Thoracic radiation in the early years of life is a known risk factor for breast cancer later in life. A 21-year-old woman who had received thoracic radiation therapy for Ewing's sarcoma of the vertebra 9 years earlier was referred to our hospital for investigation of a palpable mass in her left breast. Ultrasonography and excisional biopsy showed ductal carcinoma in situ (DCIS) of the left breast, with no detectable pathology in the right breast except that it was more hypoplastic than the left breast.

Can biliary-cyst communication be predicted before surgery for hepatic hydatid disease: does size matter?

Background: The aim of this study was to determine if there is any predictive factor indicating the risk of bile leakage before surgery for hepatic hydatid disease in clinically asymptomatic patients.

Methods: The data of 116 patients who underwent surgery for hepatic hydatid disease were reviewed retrospectively. There were 43 men (37%) and 73 women (63%) with a mean age of 45 +/- 15 years.

Recovery of sexual function after scrotal hernia repair.

Background: Most of the patients with scrotal hernia have sexual dysfunction to some extent. Therefore, we investigated the recovery of sexual function after scrotal hernia repair by using an internationally approved, patient-administered questionnaire.

Methods: In a prospective follow-up study, 34 patients with scrotal hernia were investigated to assess sexual function before and 3 months after hernia repair by using the International Index of Erectile Function (IIEF) questionnaire.

A prospective randomized trial comparing the harmonic scalpel with conventional knot tying in thyroidectomy.

Currently, thyroidectomies are performed with very little morbidity. This study was undertaken to investigate whether the use of the harmonic scalpel during thyroid surgery has any advantage over the conventional technique. Eighty patients were randomly assigned to 2 groups.

Serum endostatin levels and regenerative capacities of normal and cirrhotic livers following partial hepatectomy in mice: the response to different resection sizes.

Background: Angiogenesis has an important role in liver regeneration. Antiangiogenic response in remnant liver following resection and its relationship to regeneration is not well known. The aim of this study was to investigate the effect of hepatectomy size on serum endostatin levels, and the effect of endostatin levels to liver regeneration after partial hepatectomy in normal and cirrhotic mice.

Re-evaluation of axillary skip metastases in the era of sentinel lymph node biopsy in breast cancer.

Purpose: To investigate whether skip axillary metastases are really skip metastases or a continuation of level I micrometastases in invasive breast cancer, and to determine whether there are any factors predisposing to skip metastases.

Methods: We reviewed 568 consecutive patients with breast cancer who underwent complete axillary lymph node dissections (ALND) between January 1998 and December 2004. For patients with skip axillary lymph node metastases, resectioning and immunohistochemical staining of the remaining part of paraffin blocks from level I lymph nodes were done to determine whether there were any micrometastases in this group of lymph nodes.

Value of preoperative serum CA 19-9 levels in predicting resectability for pancreatic cancer.

Background: Pancreatic cancer carries a poor prognosis; at operation approximately 25% of patients will be found to have unresectable tumours even though CT has demonstrated that they are resectable. At our tertiary care centre, we wished to find out if there is an optimum cut-off value for the CA 19-9 level preoperatively that will indicate that the pancreatic cancer is unresectable despite radiologic imaging that suggests otherwise according to receiver operating characteristic (ROC) curve analysis.

Methods: Preoperative demographic data, clinical features and serum CA 19-9 levels were reviewed for 51 patients with pancreatic cancer who underwent laparotomy between 1998 and 2003.

Increased expression of cyclooxygenase-2 (COX-2) in radiation-induced small bowel injury in rats.

Background: Radiation therapy is a widely used adjuvant therapy for various abdominal and pelvic cancers. On the other hand, it is not a benign treatment modality, as most radiation patients suffer from some kind of radiation enteritis. Currently available treatments are only palliative and no ideal compound has as yet been discovered.

Does technique alter quality of life after pilonidal sinus surgery?

Background: Pilonidal sinus is a common disease in young adults that carries high postoperative morbidity and patient discomfort. Controversy still exists about the best surgical technique for the treatment of the disease in terms of recurrence rate and patient discomfort.

Methods: From January 2000 to November 2003, 100 consecutive age- and sex-matched patients with chronic pilonidal sinus disease were randomized to receive surgical treatment in the forms of either excision and primary closure or rhomboid excision and Limberg flap.

Evaluation of P-POSSUM and O-POSSUM scores in patients with gastric cancer undergoing resection.

Background/aims: The aim of this study was to evaluate the predictive accuracy of P-POSSUM and O-POSSUM models on patients undergoing elective gastric resection.

Methodology: P-POSSUM and O-POSSUM predictor equations for mortality were applied retrospectively to 126 patients who had undergone elective gastrectomy for cancer. Observed mortality rates were compared with rates predicted by P-POSSUM and O-POSSUM using the Hosmer-Lemeshow goodness-of-fit test.

External metallic circle in hepaticojejunostomy.

Background: Biliary-enteric anastomosis especially Roux-en Y hepaticojejunostomy is frequently used for biliary diversion in benign biliary strictures. In this study, we present the results of hepaticojejunostomy with external metallic circle.

Methods: Hepaticojejunostomy with external metallic circle were performed in eight male Sprague-Dawley rats.