Self-expandable metal stent placement for closure of a leak after total gastrectomy for gastric cancer: report on three cases and review of the literature.

In the setting of the curative oncological surgery, the gastric surgery is exposed to complicated upper gastrointestinal leaks, and consequently the management of this problem has become more critically focused than was previously possible. We report here three cases of placement of a partially silicone-coated SEMS (Evolution Controlled Release Esophageal Stent System, Cook Medical, Winston-Salem, NC, USA) in patients who underwent total gastrectomy with Roux-en-Y end-to-side esophagojejunostomy for a gastric adenocarcinoma. The promising results of our report, despite the small number of patients, suggest that early stenting (through a partially silicone-coated SEMS) is a feasible alternative to surgical treatment in this subset of patients.

Advanced endoscopic imaging for surveillance for dysplasia and colorectal cancer in inflammatory bowel disease: could the pathologist be further helped?

Patients with inflammatory bowel disease (IBD) have an increased risk of developing intestinal cancer. The magnitude of that increased risk as well as how best to mitigate it remain a topic of ongoing investigation in the field. It is important to quantify the risk of colorectal cancer in association with IBD.

Secondary aortoduodenal fistula.

Aorto-duodenal fistulae (ADF) are the most frequent aorto-enteric fistulae (80%), presenting with upper gastrointestinal bleeding. We report the first case of a man with a secondary aorto-duodenal fistula presenting with a history of persistent occlusive syndrome. A 59-year old man who underwent an aortic-bi-femoral bypass 5 years ago, presented with dyspepsia and biliary vomiting.

[Endoscopic treatment of a "gastric outlet syndrome" after Mason Vertical Banded Gastroplasty. Case report].

Introduction: Mason's Vertical Banded Gastroplasty (VBG) is characterized by peculiar complications, related to surgical pitfalls, from "outlet syndrome" (5%) to complete outlet obstruction (3%), passing to reflux oesophagitis (45%), that require redo. We report a case of "outlet syndrome" treated by operative endoscopy with success.

Materials And Methods: 40 yrs male, operated by VBG 2 years ago for morbid obesity (BMI > 40).

[Mesenteric cyst lymphangioma; a case report and literature review].

Objective: The Authors report their experience in diagnosis and treatment of one case of mesenteric cystic lymphangioma; recent international literature review.

Experimental Design: Complete clinical report. Diagnostic, clinical and prognostic indication, evaluation of effectiveness of radical surgical treatment and follow-up.

[Complications in thyroid surgery: symptomatic post-operative hypoparathyroidism incidence, surgical technique, and treatment].

Introduction: Total thyroidectomy has a definite role in the management of malignant and benign thyroid disorders, with minimal complications and rare postoperative mortality. Even though thyroid surgery is quite safe, mechanical damage, devascularization or inadvertent removal of the parathyroid glands are possible. The aim of this study is to report report the personal surgical experience and to define some of the pathologic and clinical characteristics of unintentional parathyroidectomy and post-thyroidectomy hypocalcemia.

[Infrequent early complication of mechanical digestive anastomosis: bleeding. Personal experience].

Introduction: Bleeding from mechanical digestive anastomosis is an uncommon complication (0.9-3.2%) often self-limiting but potentially lethal if not evidenced intraoperatively or in the immediate postoperative.

Trocar-related abdominal wall bleeding in 200 patients after laparoscopic cholecistectomy: Personal experience.

Aim: To determine the complications and incidence of the first and second access-related vascular injuries induced by videolaparoscopic cholecistectomy.

Methods: We retrospectively reviewed vascular injuries in 200 consecutive patients who underwent videolaparoscopic cholecistectomy from 2003 to 2005. One hundred and one patients with placement of radial expanding trocars were assigned into group A and 99 patients with placement of pyramidal tipped trocars into group B.

Presence of white bile in malignant biliary obstruction is associated with poor prognosis: personal preliminary observations.

Objective: The chemical composition and clinical significance of white bile in patients with malignant obstructive jaundice were evaluated in a prospective study.

Materials And Methods: 115 consecutive patients with inoperable malignant biliary obstruction underwent endoscopic placement of 10 Fr straight, plastic biliary stents, Amsterdam-type. Bile was aspirated during the endoscopic procedure and a blood sample was taken.

[Biliary stent placement for postoperative benign bile duct stenosis: personal experience].

Objective: To describe the management and outcome after endoscopic treatment of 23 patients with post-operative benign bile duct stricture (BBDS) managed in Authors' Department from 1991 to 2000.

Background Data: The management of the postoperative bile duct strictures remains a challenge for even the most skilled biliary tract surgeon and endoscopist. The 1990s saw a dramatic increase in the incidence of bile duct strictures from the introduction and widespread use of laparoscopic cholecystectomy.

An uncommon complication of liver biopsy: obstructive jaundice from blood clots.

Introduction: The AA. report on a case of one young woman who developed obstructive jaundice induced by hemobilia after percutaneous liver biopsy, successfully treated with endoscopic retrograde cholangiopancreatography (ERCP) METHODS: An endoscopic sphincterotomy was performed with extraction of the clots

Observations: Four weeks after ERCP the patient was healthy and asymptomatic, valuated as outpatient

Conclusions: The role of ERCP in managing biliary sequelae of hemobilia is well established: biliary decompression is required if and intrabiliary lot causes obstructive jaundice and/or biliary colic. ERCP is feasible and leads to relief of symptoms in most cases, without the need of surgery.

[Substernal goitre. Personal experience].

Introduction: Aim of the study is to discuss the diagnostic and therapeutic problems of substernal goiter (SG).

Materials And Methods: The Authors retrospectively analyzed 12 patients (3.1%) with substernal goiters among 379 patients undergoing surgical treatment for thyroid diseases from January 2000 to 2005, and evaluated the clinical data, preoperative diagnostic findings, surgical treatments, histopathological results, and postoperative complications.

Acute pancreatitis during liver hydatidosis: treatment with ERCP and endoscopic sphincterotomy.

Introduction: The Authors report on a case of a young woman who developed acute pancreatitis when affected by liver hydatidosis, successfully treated with endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy.

Methods: An endoscopic sphincterotomy was performed, with extraction of multiple hydatid membranes.

Observations: Laboratory values returned to normal within 36 hours of the sphincterotomy.

[Endoscopic palliation of obstructive jaundice caused by inoperable pancreatic cancer: personal experience].

Aim Of The Study: Few patients with pancreatic cancer are eligible for resection. In the remainder, estimation of prognosis is important to optimise various aspects of care, including palliation of biliary obstruction and trial of chemotherapy. The aim is to refer our personal experience about the palliation with endoscopic stenting in patients with unresectable pancreatic cancer.

[Videolaparoscopic cholecystectomy: personal experience].

Aim: Laparoscopic cholecystecomy (LC) is now the gold standard for the treatment of gallstones. In this report were analyzed 153 LC performed by a single surgical team and, according to results, elaborated any technical recommendation.

Materials And Methods: 153 LC has been performed in Section of General and Thoracic Surgery of University of Palermo, Sicily, by a single surgical team, since 2000.

[A rare complication of ERCP: Mallory-Weiss syndrome].

Objective: To describe the management and outcome after endoscopic treatment of hematemesis by Mallory-Weiss Syndrome (MWS) occurred after CPRE (suspected choledocolithiasis).

Background Data: Although cough and retching is common during EGD or CPRE, MWS resulting from endoscopy seems to be uncommon (0.0001-0.

[Surgical treatment of liver hydatidosis: our experience with diagnostic and therapeutic consideration].

Objective: The Authors report on their experience in diagnosis and treatment of liver hydatidosis (LH).

Materials And Methods: From January 2000 to December 2003, we observed 24 patients (10 male = 42% and 14 female = 58%, male/female ratio 1:1.4, range of age 23 - 80 years, mean age 45.

[Prevention of clogging of biliary stents by administration of levofloxacin and ursodeoxycholic acid].

One of the main advances in biliopancreatic endoscopic therapy has been the ability to palliate patients with biliary obstruction by placement of a stent during ERCP, but this is often complicated by clogging of the stent with subsequent jaundice and/or cholangitis. Stent clogging may be caused by microbiological adhesion and biliary stasis. Therefore, the use of antibiotics and choleretic agents such as levofloxacin and ursodeoxycholic acid has been investigated to see whether they prolong stent patency.