Outcome evaluation of 10,317 laparoscopic cholecystectomies: a 17-year experience at a single center.

Background/aims: This study is an analysis of the large series of laparoscopic cholecystectomies and compare our results with those reported in the literature concerning complications.

Methodology: From December 1993 to September 2010, 10,317 patients with gallstone disease underwent laparoscopic cholecystectomy. Previously operated patients were also included in the study.

Preoperative oral feeding reduces stress response after laparoscopic cholecystectomy.

Background/aims: Fasting period before surgery may change metabolic status of the patient and have influence on perioperative stress response. The aim of the study was to investigate effects of preoperative carbohydrate-rich beverage on stress response after laparoscopic cholecystectomy.

Methodology: Patients admitted for laparoscopic cholecystectomy were included into study and they were randomized into a group that was fed prior to surgery and in a group that was in the regime of nothing by mouth from the evening one day before surgery.

Influence of preoperative oral feeding on stress response after resection for colon cancer.

Background/aims: Preoperative management involves patients fasting from midnight on the evening prior to surgery. Fasting period is often long enough to change the metabolic condition of the patient which increases perioperative stress response. That could have a detrimental effect on clinical outcome.

Augmentation of regulatory T cells (CD4+CD25+Foxp3+) correlates with tumor stage in patients with colorectal cancer.

Unlabelled: Recent evidence suggests that decline of regulatory T cells (Tregs) play a critical role in the prevalence of autoimmune diseases inhibiting the maintenance of peripheral self tolerance, while its augmentation leads to insufficient antitumor response, accompanied with poor prognosis in various malignancies. Increased number of Tregs (CD4+CD25+FoxP3+) were noticed in peripheral blood mononuclear cells (PBMCs), tumor-infiltrating lymphocytes (TILs) and/or regional lymph nodes lymphocytes (LNLs) of patients with gastrointestinal tumors. The aim of our study was to investigate the correlation between the percentage of Tregs in peripheral blood of patients with colorectal carcinoma, using flow cytometric technique and tumor stages, classified as Dukes' A, B, C or D and by stage of differentiation.

Effect of pyloric dilatation on gastric emptying after pylorus-preserving pancreaticoduodenectomy.

Background/aims: Pylorus-preserving pancreaticoduodenectomy (PPPD) is the standard treatment for periampullary and pancreatic head tumors. Delayed gastric emptying (DGE) is the most common (ranging from 15-45%) but not life threatening complication and impairs patient recovery and prolongs the hospital stay after PPPD. The precise pathomechanism of DGE is still unclear.

The "round block" surgical technique in the management of multicentric fibroadenomas.

The "round block" surgical technique in the treatment of a female patient with multiple, multicentric fibroadenomas in both breasts is presented. The advantages of this technique for patients with multicentric benign breast lesions are minimal postoperative scar and a favourable aesthetic result. Breast dimensions and the areolar diameter were measured in 203 subjects of Primorsko-Goranska county during examination in the Out-Patient Hospital for Breast Diseases, including the operated patient.

Double transection of complete duodenal circumference after blunt abdominal trauma without other intra-abdominal injuries.

We report a case of a 20-year-old male with isolated complete duodenal transection at two duodenal segments after blunt abdominal trauma. On admission, the patient underwent physical examination, laboratory analysis, abdominal ultrasound and plain abdominal x-ray. Physical examination revealed diffuse and rebound tenderness and extreme rigidity of the abdomen, guarding and decreased bowel sounds.

Dupuytren's disease characteristics in Primorsko-goranska County, Croatia.

Dupuytren's disease predominantly occurs among Europeans, with higher reported prevalence in Northern than in Mediterranean European countries. We evaluated the recurrence and extension rates among Caucasian patients from Primorsko-goranska County in Croatia who underwent partial fasciectomy as treatment for Dupuytren's disease. Furthermore, we investigated the influence of diathesis factors on disease progression.

[Magnetic resonance cholangiopancreatography].

Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive imaging test with excellent overall sensitivity and specificity for demonstrating the level and presence of biliary obstruction. Selected MRCP sequences allow relatively stagnant fluids, such as bile and pancreatic juice, to have a high-signal intensity compared with the dark signal of adjacent solid organs and circulating blood, without the use of a contrast agent. Its inability to offer therapeutic interventions is a major weakness of MRCP.

Role of magnetic resonance cholangiography in the diagnosis of bile duct lithiasis.

Aim: The aim of our study was to assess diagnostic value of magnetic resonance cholangiography (MRC) in patients with suspected common bile duct (CBD) stones focusing on the capability of this noninvasive method to replace invasive diagnostic procedures in these patients and to limit the use of endoscopic retrograde cholangiography (ERC) to the patients who need simultaneous therapeutic intervention.

Materials And Methods: Single-shot fast-spin-echo rapid-acquisition thick-section MRC images were obtained in 310 patients recruited into this prospective study. There were 136 male and 174 female patients aged 21-95 years [mean +/- standard deviation (SD) 64.

The role of duplex-doppler ultrasonography in the diagnosis of renal dysfunction and hepatorenal syndrome in patients with liver cirrhosis.

Background/aims: Kidney dysfunction commonly develops in patients with liver cirrhosis. Renal failure develops due to renal vascular constriction and can be present weeks or even months before clinical signs or increased levels of blood urea nitrogen or serum creatinine concentrations become detectible. The objective of this study was to analyze the value of renal interlobar arterial resistance index, measured by duplex-Doppler ultrasonography for detecting early impairment of renal function in patients with liver cirrhosis and its possible use in detecting a subgroup of patients with a higher risk of developing hepatorenal syndrome.

Early cancer in congenital choledochal cyst.

We report a case of 35-yr-old woman with early cancer in congenital choledochal cyst. She had a five-year history of intermittent right upper abdominal pain and intermittent jaundice. In this period she had a few abdominal ultrasonographies, but the cholelithiasis had not been found.

Penetrating liver war injury: a report on 172 cases.

During the 4-year military conflict in Croatia, we treated operatively 7,928 casualties. Of those casualties, 172 (2.2%) had penetrating liver injury, mostly sustained by explosive devices.

Carpal tunnel release by limited palmar incision vs traditional open technique: randomized controlled trial.

Aim: To compare a limited palmar incision for carpal tunnel release (CTR) with a traditional open technique, which is still considered the gold standard.

Methods: Seventy-two patients with a carpal tunnel syndrome were individually randomized into the trial (limited incision CTR) (n=36) and control group (traditional technique CTR) (n=36). In the trial group, skin incision parallel to the thenar crease was made up to 2.