Lymph node ratio and liver metachronous metastases in colorectal cancer.

Aim: The authors seek to assess whether the lymph node ratio (the ratio of positive nodes divided by the total number of retrieved nodes) could predict the risk of metachronous liver metastases.

Material And Methods: A homogeneous group of 280 patients, followed-up for at least 5 years, was evaluated. In order to highlight the groups with the highest risk of metachronous liver metastases, patients were divided into four quartiles groups in relation to the LNR.

Acute hemobilia from a pseudoaneurysm of the cystic artery arising from the left hepatic artery: Case report and literature review.

Introduction: Hemobilia represents only 6% of all causes of upper gastrointestinal bleeding.

Presentation Of Case: We report a rare case of a bleeding pseudoaneurysm of the cystic artery, due to a re-activation of a chronic cholecystitis, which arose with a mixed symptomatology: jaundices and hematemesis.

Discussion: The rarity of our patient is increased for some vascular anatomic variations detected by Computed Tomography that influenced the management of the disease.

Colorectal cancer and lymph nodes: the obsession with the number 12.

Lymphadenectomy of colorectal cancer is a decisive factor for the prognostic and therapeutic staging of the patient. For over 15 years, we have asked ourselves if the minimum number of 12 examined lymph nodes (LNs) was sufficient for the prevention of understaging. The debate is certainly still open if we consider that a limit of 12 LNs is still not the gold standard mainly because the research methodology of the first studies has been criticized.

Comparative analysis of the incidence of surgical site infections in patients with liver resection for colorectal hepatic metastases after neoadjuvant chemotherapy.

Background: The aim of this study was to identify the incidence of surgical site infections (SSIs) and postoperative complications, as defined by the Clavien-Dindo classification, after hepatic resection for metastatic colorectal cancer in patients with and without associated neoadjuvant chemotherapy.

Methods: A total of 181 patients were studied retrospectively. Patients were divided into two groups: the first group comprised patients with associated neoadjuvant chemotherapeutic treatment for liver metastases with a latency time <8 wk and the second group comprised patients without associated neoadjuvant chemotherapy.

Ileo-colic endometriosis: a rare localization of a frequent disease. Case report.

Endometriosis is a common entity affecting females of reproductive age. Clinical manifestations are not specific, making the preoperative diagnosis difficult to establish. Intestinal endometriosis is common, but ethiology is unknown.

A rare case of pancreatic cancer presenting as pseudoachalasia.

"Pseudo" (or secondary) achalasia is a rare entity that it isn't easily distinguishing from idiopathic achalasia by manometry, radiological examination and endoscopy. Usually a neoplastic process of the esophago-gastric region is associated with this clinical condition. However, it has been reported that other neoplastic processes may lead to the development of pseudoachalasia, such as mediastinal masses, gastrointestinal tumours (pancreas, liver, biliary tract and other organs) and non gastrointestinal malignancies.

Bile duct injury during laparoscopic cholecystectomy without intraoperative cholangiography: a retrospective study on 1,100 selected patients.

Background: Whether to routinely or selectively use intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) has been a controversial issue for many years. Many authors maintain that IOC decreases the rate of biliary complications such as bile duct injuries, biliary leak, and missed common bile duct (CBD) stones. However, in contrast to these claims, many centers have opted to perform LC without IOC.

Does transient elastography (FibroScan®) have a role in decision making in hepatocellular carcinoma?

Objectives: Portal hypertension has been reported as a negative prognostic factor and a relative contraindication for liver resection. This study considers a possible role of fibrosis evaluation by transient elastography (FibroScan(®)) and its correlation with portal hypertension in patients with cirrhosis, and discusses the use of this technique in planning therapeutic options in patients with hepatocellular carcinoma (HCC).

Methods: A total of 77 patients with cirrhosis, 42 (54.