Chirurgia最新文献

{"title":"Advances in Gastric Carcinogenesis Related to Helicobacter Pylori.","authors":"Roxana-Florentina Chivu, Carmen Melesteu, Anca Bobirca, Dan-Andrei Dumitrescu, Ionut Melesteu, Petronel Mustatea, Florin Bobirca, Traian Patrascu","doi":"10.21614/chirurgia.3147","DOIUrl":"https://doi.org/10.21614/chirurgia.3147","url":null,"abstract":"<p><p>Helicobacter pylori (H. pylori), a Gram-negative bacterium, has been classified as a Group I carcinogen by the World Health Organization. It represents the most significant modifiable risk factor for gastric cancer (GC), particularly the intestinal subtype. Although global infection rates are on the decline, its role in gastric oncogenesis remains prominent, especially in areas with elevated incidence rates. This review consolidates current insights into the molecular and immunological pathways through which H. pylori contributes to gastric tumorigenesis, with a focus on epigenetic modulation, host-microbe interactions, and the influence of the gastric microbiota. Chronic inflammation, instigated by H. pylori infection, advances through the Correa cascade, culminating in neoplastic transformation. Principal virulence determinants, including CagA and VacA, compromise epithelial barriers and initiate oncogenic signaling networks such as NF-úB, STAT3, Wnt/ò-catenin, and Hippo/YAP. The infection is also associated with extensive epigenetic remodeling, notably promoter hypermethylation of tumor suppressor genes like CDH1, and regulation of non-coding RNAs (including miRNAs, lncRNAs, and circRNAs). Sustained colonization drives immune polarization toward Th1 and Th17 responses, promotes immune escape mechanisms such as PD-L1 overexpression, and alters the composition of the gastric microbiome. Recent findings highlight the potential role of non-H. pylori microbial species in supporting tumor progression. While eradication of H. pylori lowers the risk of gastric cancer, it does not confer complete protection, particularly in individuals with pre-existing mucosal alterations or microbial dysbiosis. The development of H. pylori-associated gastric cancer is a multifactorial process, shaped by microbial virulence, host genetics, epigenetic shifts, and immune dynamics. A deeper understanding of these interrelated mechanisms is crucial for refining preventive measures, diagnostic accuracy, and therapeutic approaches.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 3","pages":"322-344"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Celiac Trunk: Anatomical Variants and Malformations - A Narrative Review.","authors":"Maria-Teodora Popa, Octav Ginghină, Mara Mardare, Aniela Nodiţi, Alina Puşcaşu, Teodora-Mihaela Peleaşă, Adrian Miron, Alexandru Blidaru","doi":"10.21614/chirurgia.3145","DOIUrl":"https://doi.org/10.21614/chirurgia.3145","url":null,"abstract":"<p><p>The celiac trunk (CT), as the first major ventral branch of the abdominal aorta, plays a critical role in the vascularization of foregut-derived organs, including the stomach, liver, spleen, pancreas, and proximal duodenum. While the classic trifurcation pattern, known as Tripus Halleri, is observed in the majority of individuals, numerous studies have highlighted a remarkable degree of anatomical variability in its branching pattern, origin, and structural characteristics. This narrative review explores the embryological foundations, physiological anatomy, and clinical implications of CT variations, drawing upon historical and contemporary classifications - from Haller's descriptive observations to the structured systems proposed by Lipshutz, Michels, and Panagouli. Notably, deviations such as bifurcation, tetrafurcation, and even heptafurcation of the CT have been documented, with implications ranging from surgical risk in hepatobiliary procedures to complications in liver transplantation. The variability in CT morphology, influenced by developmental, genetic, and potentially ethnic factors, underscores the need for thorough anatomical knowledge in radiological diagnostics and surgical planning. By synthesizing findings from over four decades of cadaveric, radiological, and clinical studies, this review aims to provide a comprehensive understanding of CT anomalies and their relevance in modern clinical practice.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 3","pages":"303-313"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Markers for Surgical Indication in Sigmoid Volvulus with Grade II Ischemia.","authors":"Dimitrie Buşu, Vasile Sârbu, Mihaela Pundiche, Răzvan Cătălin Popescu, Daniel Ovidiu Costea, Ispas Viorel, Andrei Dumitru, Cristina Tocia, Ioana Popescu, Ispas Sorina, Nicoleta Leopa","doi":"10.21614/chirurgia.3148","DOIUrl":"https://doi.org/10.21614/chirurgia.3148","url":null,"abstract":"<p><p><b>Background:</b> Grade II ischemia in sigmoid volvulus presents challenges in surgical decision-making. This study compares outcomes between patients undergoing sigmoid resection during the first episode versus at recurrence. <b>Methods:</b> A retrospective analysis of 63 patients with intraoperatively confirmed Grade II ischemia treated between 2018-2024 was performed. All underwent initial endoscopic decompression followed by surgical resection - either during the first episode (Group I, n=41) or at recurrence (Group II, n=22). Demographic, biochemical, and surgical outcomes were compared. <b>Results:</b> Biochemical markers - including white blood cell count, CRP, D-dimer, serum lactate, and creatinine - were significantly elevated in recurrent cases (all p 0.001). Lower blood pH values were observed in recurrent cases (7.23 vs. 7.29, p 0.001) consistent with systemic acidosis. Operative time and intraoperative blood loss were higher in the recurrent group, and primary anastomosis was performed only in the first-episode group. Postoperative complications were more common in recurrent cases (31.8% vs. 12.2%, p=0.064), and length of stay was longer (8.64 vs. 6.32 days, p 0.001). <b>Conclusions:</b> Delayed surgery at recurrence is associated with worsened inflammation, metabolic derangement, and higher surgical risk. Early surgery during the first episode offers better clinical outcomes.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 3","pages":"247-254"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic Abscess as a Rare Late Complication of Perforated Appendicitis. A Case Presentation.","authors":"Martino Gerosa, Francesca Roufael, Chiara Lasagna, Fabiana Di Monte, Richard Sassun, Annaclara Sileo, Mauro Santonocito, Barbara Vignati, Nicola Zarpellon, Roberto Cirocchi, Dario Maggioni, Giulio Maria Mari","doi":"10.21614/chirurgia.3101","DOIUrl":"https://doi.org/10.21614/chirurgia.3101","url":null,"abstract":"<p><p><b>Background:</b> Acute appendicitis is a common surgical emergency, predominantly affecting young males. Although laparoscopic appendectomy reduces adverse outcomes, potential complications related to this condition are known. Among these, hepatic abscess is a rare and severe complication, with limited cases reported in the literature. Case Report: We report a case of an 18-years-old male with diffuse purulent peritonitis due to perforated appendicitis who developed a hepatic abscess one month post-surgery. Despite the initial management including surgical intervention and antibiotic therapy, after one month the patient presented with high temperature and right upper quadrant pain, leading to the discovery and subsequent percutaneous drainage of a hepatic abscess and intravenous antibiotic therapy. The abscess culture identified Bacteroides Fragilis, guiding targeted antibiotic therapy and resulting in a full recovery. <b>Discussion:</b> This case highlights the potential for hepatic abscess formation following acute appendicitis, suspected to arise from hematogenous bacterial spread. Given the uncommon nature of this complication, a high index of suspicion in patients presenting with unusual symptoms post-appendectomy is required. Immediate percutaneous drainage alongside broad-spectrum antibiotic therapy, followed by targeted treatment upon pathogen identification, is crucial for managing this life-threatening condition. Conclusion: Although rare, hepatic abscess can occur as a complication of acute appendicitis, underscoring the importance of awareness and prompt intervention to prevent severe outcomes. Percutaneous drainage of the abscess associated to a targeted antibiotic therapy represents the treatment of choice.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 3","pages":"355-360"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of Laparoscopic Gastroplication on Quality of Life and Post-Operative Outcomes in Obese Patients.","authors":"Mihnea Bogdan Borz, Aurelio Pio Russo, Oliviu Cristian Borz","doi":"10.21614/chirurgia.3089","DOIUrl":"https://doi.org/10.21614/chirurgia.3089","url":null,"abstract":"<p><p><b>Background:</b> Obesity has emerged as a global pandemic, manifesting as metabolic, social, and psychological disorders. Traditional bariatric approaches have long been the cornerstone of obesity treatment; however, laparoscopic greater curvature plication (LGCP) has gained recognition as a viable, minimally invasive alternative. Aim of the study: The aim of this study is to evaluate the impact of LGCP on weight loss, obesity-related comorbidities, and quality of life in patients with a Body Mass Index (BMI) =35 kg/m². <b>Materials and Methods:</b> A retrospective analysis was conducted on 50 patients (45 women and 5 men) who underwent LGCP. The average preoperative BMI was 38.71 kg/m². Inclusion criteria targeted patients with a BMI =35 kg/mò with obesity-related comorbidities or =40 kg/m² regardless of comorbidity status. Preoperative and postoperative data collection included BMI measurements, comorbidity status, and quality of life, assessed through the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire. <b>Results:</b> At one year postoperatively, the average excess body weight loss percentage (EBWL%) reached 64.43%, peaking at 79.31% at 18 months, with stabilization at 65.13% by the two-year mark. The average BMI decreased from 38.71 kg/m² preoperatively to 30.35 kg/m² at two years postoperatively. Obesity-related comorbidities showed significant improvement: 15 out of 16 patients with dyslipidemia and 10 out of 12 with hyperglycemia experienced resolution or improvement, while all 18 patients with joint pain reported symptom relief. <b>Conclusions:</b> LGCP has proven to be an effective bariatric procedure, delivering substantial weight loss and improving obesity-related conditions and QOL in patients with a BMI =35 kg/m². Despite these favorable outcomes, long-term success remains contingent on patient adherence to lifestyle modifications and postoperative guidelines.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 3","pages":"275-284"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Management of Retinoblastoma. A 10-year Retrospective Analysis from North-Eastern Romania.","authors":"Vlad Constantin Donica, Claudia Florida Costea, Călina Anda Sandu, Irina Andreea Pavel, Camelia Margareta Bogdănici","doi":"10.21614/chirurgia.3109","DOIUrl":"https://doi.org/10.21614/chirurgia.3109","url":null,"abstract":"<p><p><b>Introduction:</b> Retinoblastoma is the most common pediatric ocular tumor and the lack of proper genetic testing and case registration represents an important cause for advanced stage disease at initial presentation. Material and <b>Methods:</b> A 10-year retrospective analysis of patients diagnosed with retinoblastoma between 2014- 2024 in â??Sf. Spiridonâ? Hospital, Iasi, Romania was performed, focusing on patient gender, age at presentation, Rb clinical stage, growth pattern, histological aspects and treatment type. <b>Results:</b> Unilateral tumors were found in 9/10 patients, one patient having bilateral tumor. Average age was 25.9 months, with 7 male and 3 female patients. All were diagnosed with disease stage E. Enucleation with successful tumor excision was performed in 6/7 cases. Two patients received conservative treatment and one patient was unable to be reached. 42.85% of tumors were classified as grade G2, and 57.15% as G3. 71.42% of cases had optic disc invasion with further nerve invasion in 40%. Uveal invasion was present in 57.14% of cases. Conclusion: This analysis provides insights into treatment options and long-term prognosis for children with retinoblastoma from the north-eastern part of Romania. This analysis highlights the need to enhance screening measures for infants, because of the advanced stage of retinoblastoma at presentation.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 3","pages":"294-302"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four Different Pathologic Conditions of the Descending Aorta - One Hybrid Solution: Thoracic Endovascular Aortic Repair with Partial Debranching of the Aortic Arch. A Series of 6 Cases.","authors":"Horaţiu Moldovan, Lucian Câlmâc, Marian Broască, Maria Sabina Safta, Bogdan Severus Gaşpar, Claudia Nica, Andrada Guţă, Liliana Mirea, Cristian Voica, Costin Minoiu, Aida Badea, Elena Nechifor, Silvia Preda, Mircea Robu, Alexandru Zăman, Andrada Bogdan","doi":"10.21614//chirurgia.3066","DOIUrl":"10.21614//chirurgia.3066","url":null,"abstract":"<p><p><b>Introduction:</b> We report our experience of six patients admitted to our hospital during January - July 2023 with complex aortic conditions treated with a two-stage hybrid procedure, consisting of surgical debranching - bypass grafting - of the supra-aortic branches off-pump and stent graft placement for Thoracic Endovascular Aortic Repair (TEVAR). Clinical features: The clinical cases we present highlight the use of TEVAR in both chronic (Type B aortic dissections, pseudoaneurysms, and penetrating aortic ulcers) and acute conditions (traumatic aortic transections and ruptured aortic aneurysms). TEVAR is a less invasive surgical approach for management of these critical patients, having as benefits: smaller incisions, avoiding operative risks associated with the classical procedure, shorter recovery time after the intervention and lower hospitalization costs. <b>Conclusions:</b> TEVAR offers an alternative to open surgery, showing better immediate and mid-term results, as well as providing the chance to solve a variety of both chronic and acute cases that would be otherwise classified as too high risk for classic open surgery.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 3","pages":"345-354"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Overview of Acute Pancreatitis: Role of the Prediction Scores for the Assessment of Severity.","authors":"Giuseppe Evola, Marco Vacante, Francesco Roberto Evola, Giuseppe Angelo Reina, Grazia Maugeri, Giuseppe Musumeci, Velia D'Agata, Guido Basile","doi":"10.21614/chirurgia.3117","DOIUrl":"https://doi.org/10.21614/chirurgia.3117","url":null,"abstract":"<p><p>Acute pancreatitis is a serious inflammatory condition of the pancreas that can be life-threatening, with the approach to treatment depending on the severity of the disease. Diagnosing acute pancreatitis, predicting its severity, and assessing prognosis generally involve imaging techniques like computed tomography, magnetic resonance imaging and ultrasound, along with scoring systems such as Ranson, Acute Physiology and Chronic Health Evaluation II (APACHE II), and the Bedside Index for Severity in Acute Pancreatitis (BISAP). Computed tomography is regarded as the gold standard due to its high sensitivity and specificity, while magnetic resonance imaging and ultrasound offer valuable insights into biliary obstruction and vascular issues. These scoring systems help categorize patients based on clinical and laboratory data into mild, moderate, or severe levels, influencing treatment decisions like intensive care unit admission, early enteral feeding, and the use of antibiotics. However, despite the importance of these imaging and scoring methods in managing acute pancreatitis, they face challenges in terms of accuracy, consistency, practicality, and cost-effectiveness. In this review we aimed at discussing the clinical usefulness of the most important scoring systems for prediction of severity in this complex disease.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 3","pages":"314-321"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Personalized Surgery in Advanced Prostate Cancer: Stratification by PTEN, AR-V7, TP53, TMPRSS2-ERG, and ERBB2 Genetic Alterations.","authors":"Cristina Anita Ionescu, Georgeta Camelia Cozaru, Mariana Aşchie, Nicoleta Leopa, Bogdan Cîmpineanu, Felix Voinea, Elena Matei, Anca Mitroi, Mariana Deacu, Ionuţ Iorga, Mihaela Pundiche","doi":"10.21614/chirurgia.3151","DOIUrl":"https://doi.org/10.21614/chirurgia.3151","url":null,"abstract":"<p><p><b>Background:</b> Advanced prostate cancer is a biologically heterogeneous disease often marked by multiple genetic and epigenetic alterations that influence tumor progression, treatment resistance, and prognosis. Among the most frequently altered genes are PTEN, AR-V7, TP53, TMPRSS2-ERG, and ERBB2, each with potential relevance for stratifying risk and guiding targeted therapy. <b>Methods:</b> This retrospective study included 43 patients with advanced prostate cancer who underwent radical prostatectomy. Tumor specimens were analyzed using fluorescence in situ hybridization (FISH) to assess the mutational status of the five markers. Clinicopathological parameters, including PSA levels, Gleason score, tumor stage, and invasion status, were correlated with molecular alterations using multinomial logistic regression. <b>Results:</b> The most common isolated alteration was PTEN loss (20.9%), followed by TP53 amplification (16.3%), TMPRSS2-ERG fusion (13.9%), AR-V7 expression (11.6%), and ERBB2 amplification (7%). Combined alterations were also observed, with dual or triple marker expression in select aggressive cases. PTEN- and AR-V7+ were associated with low PSA values despite aggressive pathology, while ERBB2+ correlated with high PSA levels and high Gleason scores. TP53+ and ERBB2+ were also significantly associated with high-grade tumors (Gleason 7). AR-V7+ was the only marker significantly associated with seminal vesicle invasion. Younger age was weakly correlated with AR-V7+ and TP53+ status. <b>Conclusions:</b> The molecular profile defined by PTEN, AR-V7, TP53, and ERBB2 identifies distinct biological subtypes in advanced prostate cancer, each with specific prognostic and therapeutic implications. Integration of these biomarkers into routine clinical assessment may improve treatment personalization and risk stratification. Validation in larger, prospective cohorts is warranted.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 3","pages":"265-274"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Factors in Acute-on-Chronic Pancreatitis: Insights from a Romanian Tertiary Center Cohort.","authors":"Petruta Violeta Filip, Corina Silvia Pop, Laura Sorina Diaconu, Flori Elena Tapu, Nicoleta Tiuca, Dana Galieta Mincă","doi":"10.21614/chirurgia.3137","DOIUrl":"https://doi.org/10.21614/chirurgia.3137","url":null,"abstract":"<p><strong>Background/aims: </strong>This study aimed to assess and compare the severity of acute pancreatitis (AP) in patients with and without underlying chronic pancreatitis (CP). <b>Methods:</b> We included patients diagnosed with AP and categorized them into those with CP and those without CP. Disease severity was defined by the presence of organ failure, intensive care unit (ICU) admission, or mortality. <b>Results:</b> ACP accounted for 25.85% of all AP cases in the study. Patients with ACP were more commonly male smokers with low BMI, lower albumin levels, and higher Balthazar scores. In contrast, patients with AP (without CP) had significantly higher heart rates (HR), Balthazar, and CTSI scores. Length of hospitalization and mortality rate were higher in those patients with AP, who were associated with a high rate of organ dysfunction. Prognostic factors influencing survival at 72 hours were respiratory failure, creatinine/albumin ratio, BISAP, albumin levels, and AKI. Meanwhile, survival at 30 days was influenced by respiratory failure, the creatinine/albumin ratio, and blood urea nitrogen. <b>Conclusions:</b> Compared to AP without CP, ACP is associated with a less severe disease course, lower mortality, reduced organ failure, and shorter ICU stays. However, ACP is more frequently observed in male smokers with lower BMI and albumin and higher CTSI and Balthazar scores.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 3","pages":"285-293"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}