Effects of Pancreatic Fistula After Minimally Invasive and Open Pancreatoduodenectomy.

Importance: Postoperative pancreatic fistulas (POPF) are the biggest contributor to surgical morbidity and mortality after pancreatoduodenectomy. The impact of POPF could be influenced by the surgical approach.

Objective: To assess the clinical impact of POPF in patients undergoing minimally invasive pancreatoduodenectomy (MIPD) and open pancreatoduodenectomy (OPD).

Impact of patient age on outcome of minimally invasive versus open pancreatoduodenectomy: a propensity score matched study.

Background: Pancreatoduodenectomy in elderly patients may be associated with increased postoperative mortality, but studies in minimally invasive pancreatoduodenectomy (MIPD) are scarce.

Methods: International multicenter retrospective study including patients aged >60 years undergoing MIPD (robot-assisted and laparoscopic) and open pancreatoduodenectomy (OPD), were categorized by age: 60-69, 70-79, and 80+ years. In each category, propensity score matching (PSM) was performed (1:1 ratio) between MIPD and OPD.

Predictive value of drain fluid amylase level on postoperative day one after pancreatic resection for predicting postoperative pancreatic fistula.

Objectives: The aim of this study was to evaluate the predictive value of the first postoperative day (POD1) drain fluid amylase in predicting pancreatic fistula formation following pancreaticoduodenectomy (PD).

Material And Methods: One-hundred and eighty-five prospective patients undergoing PD between April 2014 and April 2018 were studied retrospectively. Cut-off point to predict the development of POPF was determined by median values for drain fluid amylase of 1883 U/L.

Histopathological evaluation after pancreatic surgery: Comparison of the results of HPB-specific pathologists and non-specific pathologists.

Objectives: The aim of this study was to compare the results of the evaluation of HPB-specific pathologists and general pathologists on the specimens of patients who underwent pancreaticoduodenectomy by the same surgical team.

Material And Methods: The pathological results of 159 patients who underwent pancreaticoduodenectomy (PD) in the periampullary region was retrospectively examined. Histopathological evaluation results of HPB-specific pathologist (S group) and other pathologists (NS group) were compared.

Outcomes After Minimally Invasive Versus Open Total Pancreatectomy: A Pan-European Propensity Score Matched Study.

Objective: To assess postoperative 90-day outcomes after minimally invasive (laparoscopic/robot-assisted) total pancreatectomy (MITP) in selected patients versus open total pancreatectomy (OTP) among European centers.

Background: Minimally invasive pancreatic surgery is becoming increasingly popular but data on MITP are scarce and multicenter studies comparing outcomes versus OTP are lacking. It therefore remains unclear if MITP is a valid alternative.

Stage predictivity of neutrophil/lymphocyte and platelet/lymphocyte ratios in pancreatic neuroendocrine tumors.

Objectives: This study aimed to analyze the correlations between European Neuroendocrine Tumor Society (ENEST), Tumor Node Metastasis (TNM) staging systems and pre-operative neutrophil/lymphocyte (NLR) and platelet/lymphocyte ratios (PLR) in patients with pancreatic neuroendocrine tumor (PNET).

Material And Methods: Forty-four patients with diagnosed PNET were analyzed retrospectively. Accordingly, the patients' blood and clinicopathological parameters were analyzed.

Prevention of inadvertent injury to aberrant hepatic artery arising from superior mesenteric artery during laparoscopic pancreaticoduodenectomy.

Laparoscopic pancreatoduodenectomy is a challenging surgical procedure. Presence of aberrant hepatic artery arising from the superior mesenteric artery increases the complexity througout dissection. Herein we propose some important points and tricks that help surgeon avoid an inadverdent injury to aberrant hepatic artery during laparoscopic pancreatoduodenectomy.

Intra-Operative Frozen Section Histology of the Pancreatic Resection Margins and Clinical Outcome of Patients with Adenocarcinoma of the Head of the Pancreas Undergoing Pancreaticoduodenectomy.

BACKGROUND The aim of this study was to compare the clinical outcome in patients with pancreatic ductal adenocarcinoma who underwent frozen section and paraffin section histology of the surgical resection margins during pancreaticoduodenectomy. MATERIAL AND METHODS Frozen section and routine paraffin section histopathology were performed using the following categories: R0 (no tumor cells at the surgical resection margin), R1 (tumor cells at, or within 1 mm, of the surgical resection margin), and R2 (tumor seen macroscopically at the surgical resection margin). R1 and R2 patients underwent additional resection to achieve R0.

A case of Brunner's gland adenoma mimicking tumors induced from head of the pancreas.

Brunner's Gland Adenoma is a very rarely seen benign tumor of duodenum. While it generally leads to obstruction and bleeding complaints, it may very rarely occur by mimicking a pancreatic tumor. A 48 years old male patient admitted to the gastroenterology clinic due to the epigastric pain spreading dorsally.

Outcomes After Minimally-invasive Versus Open Pancreatoduodenectomy: A Pan-European Propensity Score Matched Study.

Objective: To assess short-term outcomes after minimally invasive (laparoscopic, robot-assisted, and hybrid) pancreatoduodenectomy (MIPD) versus open pancreatoduodenectomy (OPD) among European centers.

Background: Current evidence on MIPD is based on national registries or single expert centers. International, matched studies comparing outcomes for MIPD and OPD are lacking.

A Case Report of Bilateral Adrenal Sarcomatoid Carcinoma.

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Sarcomatoid adrenal carcinoma is even more aggressive type of ACC. Bilateral malignant adrenal tumors are extremely rare except for those that represent metastasis from an extra-adrenal organ.

Turkish Ministry of Health, 2 Turkish Medical General Assembly Clinical Oncology Study Group Report.

Objective: There is an increase in the incidence of cancer, and consequently in mortality rates, both in the world and in Turkey. The increase in the incidence and mortality rate of cancer are more prominent in our country as well as in other developing countries. The aim of this workshop was to determine the current status on prevention, screening, early diagnosis and treatment of cancer in our country, to identify related shortcomings, specify solutions and to share these with health system operators, and to aid in implementation of these systems.

Increased Resistin Levels in Intra-abdominal Sepsis: Correlation with proinflammatory cytokines and Acute Physiology and Chronic Health Evaluation (APACHE) II scores.

Objectives: Resistin, a hormone secreted from adipocytes and considered to be a likely cause of insulin resistance, has recently been accepted as a proinflammatory cytokine. This study aimed to determine the correlation between resistin levels in patients with intra-abdominal sepsis and mortality.

Methods: Of 45 patients with intra-abdominal sepsis, a total of 35 adult patients were included in the study.

PPAR-alpha agonist treatment increases trefoil factor family-3 expression and attenuates apoptosis in the liver tissue of bile duct-ligated rats.

Background/aims: Peroxisome proliferators-activated receptor alpha activation modulates cholesterol metabolism and suppresses bile acid synthesis. The trefoil factor family comprises mucin-associated proteins that increase the viscosity of mucins and help protect epithelial linings from insults. We evaluated the effect of short-term administration of fenofibrate, a peroxisome proliferators activated receptor alpha agonist, on trefoil factor family-3 expression, degree of apoptosis, generation of free radicals, and levels of proinflammatory cytokines in the liver tissue of bile duct-ligated rats.

Giant serous microcystic pancreas adenoma.

Serous cystadenomas are rare tumors comprising 1-2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females.

Hepatotoxicity associated with lapatinib in an experimental rat model.

Background: The current study is the first to evaluate the biochemical and histopathological features of hepatic toxicity of lapatinib.

Methods: Twenty Wistar albino rats were allocated into three groups: experimental toxicity was induced with lapatinib (10mg/kg) administered for 28 days (Group 1), 42 days (Group 2) orally in a single dose by gavage. Control group received only sterile water.

The timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreaticography in cholelithiasis coexisting with choledocholithiasis.

Background: An accepted treatment strategy for cholelithiasis with secondary choledocholithiasis is the laparoscopic cholecystectomy (LC) following endoscopic retrograde cholangiopancreaticography (ERCP). Although early cholecystectomy is advised, there is no consensus about the time interval between LC and ERCP. The aim of this study is to evaluate the effects of the time interval between ERCP and ERCP on operation outcomes.

Administration of Chlorella sp. microalgae reduces endotoxemia, intestinal oxidative stress and bacterial translocation in experimental biliary obstruction.

Rationale: Endotoxemia has long been documented in obstructive jaundice, and altered intestinal barrier function is considered to be one of the important mechanisms for this phenomenon. The aim of this study was to investigate the role of different microalgae (Chlorella sp. and Spirulina sp.

Exogenous ghrelin enhances endocrine and exocrine regeneration in pancreatectomized rats.

Aim: Ghrelin, the most important modulator of endocrine and exocrine pancreatic functions, has a role in the development of islets of Langerhans during embryogenesis. The aim of this study was to evaluate the effects of ghrelin on pancreatic regeneration in rats with 90% pancreatectomy.

Materials And Methods: Two- to 3-week-old Wistar rats were used in the study.

Effects of microalgae Chlorella species crude extracts on intestinal adaptation in experimental short bowel syndrome.

Aim: To evaluate the effects of chlorella crude extract (CCE) on intestinal adaptation in rats subjected to short bowel syndrome (SBS).

Methods: Wistar rats weighing 230-260 g were used in the study. After anesthesia a 75% small bowel resection was performed.

Adipokines and ghrelin in gastric cancer cachexia.

Aim: To investigate the roles of the adipocytokines, ghrelin and leptin in gastric cancer cachexia.

Methods: Resistin, ghrelin, leptin, adiponectin, insulin and insulin-like growth factor (IGF-I), were measured in 30 healthy subjects, and 60 gastric cancer patients of which 30 suffered from cancer-induced cachexia and 30 served as a control group. The relationships between hormones, body mass index (BMI) loss ratio, age, gender, and Glasgow Prognostic Score (GPS) were investigated.

Effect of adrenomedullin on hepatic damage in hepatic ischaemia/reperfusion injury in rats.

Aims: Adrenomedullin (AM) is a multifunctional peptide with a putative beneficial role after an ischaemic insult. The aim of this study was to evaluate the effect of AM on partial hepatic ischaemia reperfusion (I/R) injury.

Methods: Rats were subjected to 1 h of 70% hepatic ischaemia, followed by reperfusion or sham.

Hepatic energy metabolism and the differential protective effects of sevoflurane and isoflurane anesthesia in a rat hepatic ischemia-reperfusion injury model.

Background: We investigated the effects of isoflurane and sevoflurane in a warm liver ischemia-reperfusion (IR) model on cytokines, hepatic tissue blood flow (HTBF), energy content, and liver structure.

Methods: Seventy-two Wistar rats were randomly assigned into 1 of 3 groups: Control group, no volatile anesthetics; sevoflurane group, 2% sevoflurane; isoflurane group, 1.5% isoflurane.

Wegener's granulomatosis with massive gastrointestinal hemorrhage due to jejunal and colonic involvement: report of a case.

Wegener's granulomatosis (WG) is a systemic necrotizing vasculitis of unknown etiology characterized mainly by the involvement of the upper airways, lungs, and kidneys. Although most organ systems can be involved, gastrointestinal involvement in WG is notably uncommon. We herein present the case of a WG patient who developed two massive gastrointestinal hemorrhages treated respectively by surgery and angiographic embolization of the bleeding artery.