Isolated splenic cystic echinococcosis and albendazole hepatotoxicity.

Isolated splenic cystic echinococcosis is a rare condition. In Greece the number of cases has declined substantially in the last 20 years. The spleen is the second most common extrahepatic site of cystic echinococcosis.

Intestinal neurofibromatosis and small-bowel adenocarcinoma: a single case study.

Patients with Von Recklinghausen's disease (neurofibromatosis type 1) are at increased risk of developing various tumours. However, the coexistence of neurofibromatosis with small-bowel adenocarcinoma is exceedingly rare. We present an uncommon case of neurofibromatosis type 1, involving the small bowel in a 73-year-old man, who was admitted to our department with signs of acute abdomen.

Impact of immunosuppression on the incidence of early subclinical renal allograft rejection: implications for protocol biopsy policy.

In order to determine the impact of immunosuppression (IS) on the incidence of early subclinical rejection (SCR), we studied two groups of patients receiving different immunosuppressive regimens. Patients received cyclosporin (CsA), azathioprine and prednisolone (group 1; n = 304) or IS according to immunological risk (group 2; n = 150). The highest-risk patients received basiliximab induction, tacrolimus, mycophenolate mofetil (MMF) and prednisolone; medium-risk patients CsA, MMF and prednisolone; low-risk CsA, azathioprine and prednisolone.

Risk factors for delayed graft function defined as need for dialysis or failure of creatinine to fall by 10% in the first 24 hours after transplant.

Objectives: Delayed graft function after deceased-donor transplant remains a significant clinical problem. The conventional definition of delayed graft function is the requirement of dialysis within the first week after transplant, but this criterion has many problems that have led to many controversies including those of incidence and significance. Therefore, we sought to identify the possible risk factors of delayed graft function and to investigate their effect on short-term graft survival, according to a composite criterion.

Role of the reverse-Trendelenberg patient position in maintaining low-CVP anaesthesia during liver resections.

Background And Aims: The Trendelenberg position is recommended during liver resection, to decrease the risk of venous air embolism. However, this position raises the central venous pressure and may increase blood loss. We propose that the reverse-Trendelenberg position can be safely and effectively used to maintain a low central venous pressure during liver surgery.

Central hepatectomy: the golden mean for treating central liver tumors?

The treatment of patients with central liver tumors involving segments 4, 5 and 8 is a difficult clinical problem. These tumors often straddle Cantlie's line and involve parts of both lobes of the liver. The traditional management of such tumors is to perform either an extended right or an extended left hepatectomy.

Surgical techniques and treatment for hepatic hydatid cysts.

Purpose: Hepatic hydatid cysts (HHCs) are a parasitic infestation caused by several species of Echinococcus. We examined the clinical features of HHCs and evaluated the results of various surgical procedures.

Methods: One hundred and sixty-nine patients aged between 17 and 84 years underwent surgery for HHCs within a 12-year period.

Localisation and surgical treatment of insulinomas.

Most insulinomas are solitary, benign and functional neuroendocrine pancreatic tumours which give rise to manifold symptoms. Their preoperative localisation is often unclear, but the cure rate after their excision is very high. It was the aim of this study to analyse and evaluate our group of patients with regard to preoperative tumour localisation and overall surgical results.

Lichtenstein tension-free repair of inguinal hernia.

Recurrences have been a significant problem following hernia repair. The purpose of this study was to present our experience of Lichtenstein tension-free repair of inguinal hernia. In this retrospective study, 223 inguinal hernia repairs were performed between September 2000 and August 2003 in 203 patients, using a polypropylene mesh.

Total parathyroidectomy with autotransplantation in patients with renal hyperparathyroidism: indications and surgical approach.

Objective: renal hyperparathyroidism (rH) is one of the most serious complications in long-term hemodialysis patients. the purpose of this retrospective study was the evaluation of the surgical indications, parathyroid histology, and the results of total parathyroidectomy with autotransplantation (Ptx+At) in patients with rH.

Design: the study included 36 patients with rH in whom Ptx+At was carried out at the First surgical Department of the Evangelismos Hospital over a 5-year period.

Hepatopancreatoduodenectomy for metastatic duodenal gastrointestinal stromal tumor.

Background: Duodenal gastrointestinal stromal tumors, which are rare, comprise 3%-5% of all gastrointestinal stromal tumors. We present a case of a metastatic duodenal gastrointestinal stromal tumor that was successfully treated by simultaneous right hemihepatectomy and pancreaticoduodenectomy.

Methods: A 50-year-old woman was admitted to our department for the treatment of a possible metastatic duodenal gastrointestinal stromal tumor (GIST).

Changes in liver histology accompanying massive weight loss after gastroplasty for morbid obesity.

Background: Nonalcoholic steatohepatitis (NASH) is common in morbid obesity. Our goal was to evaluate the alterations in liver histology and biochemistry before and after weight loss in 51 morbidly obese patients following Mason's vertical banded gastroplasty.

Methods: Two biopsies were performed (on entry and after an average of 18 months), while 16 of these subjects had a third biopsy 17 months after the second.

Gastric cancer occurring after vertical banded gastroplasty.

A case of gastric cancer after vertical banded gastroplasty (VBG) is presented. A 44-year-old man presented with vomiting and weight loss 6 years after VBG. Endoscopy revealed a poorly differentiated gastric adenocarcinoma.

Bleeding from the upper gastrointestinal tract after Mason's vertical banded gastroplasty.

Background: Gastric bleeding is a rare complication after a vertical banded gastroplasty (VBG). Only a few cases of gastric bleeding after a VBG have been reported, and there is discussion about its etiology. We present two cases of gastric bleeding after a VBG, and discuss the etiology, diagnostic approach and management.

Ulcerative colitis and acute stroke: two rare complications after Mason's vertical banded gastroplasty for treatment of morbid obesity.

The authors present a very rare case of ulcerative colitis and acute stroke appearing as complications after Mason's vertical banded gastroplasty for treatment of morbid obesity in a 46-year-old man. On the basis of recent studies, the authors attempt to find the correlation of these three diseases and the possible effect of each disease on the appearance of the others. The dilemmas in the treatment of this patient are also described.