Surgery, Gastroenterology and Oncology最新文献_第10页

Combined Endoscopic-Radiologic Minimally Invasive Rescue Technique for the Removal of a Migrated and Embedded Biliary Metal Stent 内镜-放射联合微创胆道金属支架移置术的应用

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI: 10.21614/sgo-26-4-388

P. Antypas, M. Corona, Cristian Eugeniu Boru, Chiara Eberspacher, D. Mascagni, F. Fiocca

{"title":"Combined Endoscopic-Radiologic Minimally Invasive Rescue Technique for the Removal of a Migrated and Embedded Biliary Metal Stent","authors":"P. Antypas, M. Corona, Cristian Eugeniu Boru, Chiara Eberspacher, D. Mascagni, F. Fiocca","doi":"10.21614/sgo-26-4-388","DOIUrl":"https://doi.org/10.21614/sgo-26-4-388","url":null,"abstract":"Bile duct injuries represent a rare but potentially serious complication after laparoscopic cholecystectomy, that often need multidisciplinary therapeutic approaches. Additionally, post cholecystectomy clip migration into the biliary tree has been described, mainly because of local inflammatory processes. We present a case of a 65-year-old male with a bile duct injury and stricture after laparoscopic cholecystectomy treated endoscopically with sphincterotomy and stent positioning; initially with a plastic 10Fr stent and later with a totally covered metal stent. At the removal, the metal stent appeared proximally migrated and embedded with a surgical clip, the latter also migrated into the bile duct. The endoscopic retrieval of the stent was unsuccessful and thus a simultaneous right percutaneous transhepatic approach was adopted to liberate the stent and to facilitate the endoscopic procedure. The combined endoscopic-radiologic minimally-invasive approach seemed to be an effective and safe rescue technique, avoiding in this way complex surgical procedures.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81116015","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}

引用次数: 0

Modified Blumgart Anastomosis in Patients Undergoing Robotic Pancreaticoduodenectomy: The Results of a Preliminary Experience 改良Blumgart吻合在机器人胰十二指肠切除术中的应用:初步经验的结果

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI: 10.21614/sgo-26-4-393

M. Marino, Adrian Chiow Kah Heng, G. Vaccarella, O. Potapov, Andrzej Lech Komorowski

{"title":"Modified Blumgart Anastomosis in Patients Undergoing Robotic Pancreaticoduodenectomy: The Results of a Preliminary Experience","authors":"M. Marino, Adrian Chiow Kah Heng, G. Vaccarella, O. Potapov, Andrzej Lech Komorowski","doi":"10.21614/sgo-26-4-393","DOIUrl":"https://doi.org/10.21614/sgo-26-4-393","url":null,"abstract":"Backgrounds: Several anastomoses have been described for the reconstruction of the pancreatic stump after pancreaticoduodenectomy. No technique showed a superiority over the others in terms of post-operative pancreatic fistula formation (POPF) in open neither during a minimally invasive approach. Methods: We compared the surgical outcomes of fourteen patients classified as high-risk for POPF who underwent a Blumgart anastomosis (BA) with that of patients who underwent a Cattell-Warren (CW). A 1:1 case-matched analysis was performed according to the variables of the risk score for post-operative pancreatic fistula (POPF) formation. Results: The overall operative time was similar (373±115 vs 398±127 min, p=0.567) while fashioning of the CW anastomosis required a longer time (38±21 vs 29±10, p<0.05). The overall morbidity rate was comparable among the two groups (p=0.273), while the incidence of clinically relevant-POPF was lower in the BA group (0 vs 3, p<0.05). No differences were observed in reoperation rate (p=0.445) and in postoperative length of stay (11.5 vs 12.6, p=0.367). Conclusion: The BA anastomosis is a potential alternative to the CW technique in a high-risk population for POPF formation. It shows benefits in terms of shorter anastomotic time and lower rate of clinically relevant-POPF.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85936705","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}

引用次数: 0

A Rare Liver Tumor: Case Report and Literature Review 罕见肝脏肿瘤1例报告及文献复习

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI: 10.21614/sgo-ec-350

Choi Chin Wa, Leong Chin Wan, Iao Kin Sang, Chu Man Leng, J. Costa-Maia, Pang Heong Keong

引用次数: 0

Inflammatory Responses in Liver Transplantation 肝移植中的炎症反应

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI: 10.21614/SGO-26-326

Kantoku Nagakawa, A. Soyama, S. Eguchi

{"title":"Inflammatory Responses in Liver Transplantation","authors":"Kantoku Nagakawa, A. Soyama, S. Eguchi","doi":"10.21614/SGO-26-326","DOIUrl":"https://doi.org/10.21614/SGO-26-326","url":null,"abstract":"Successful liver transplantation requires proper mitigation of stress responses. Systemic effects caused by liver cirrhosis, invasive surgery, ischemia-reperfusion injury, rejection, and infection, all of which are relevant to liver transplantation, are mediated by inflammatory factors. Recently, the detailed mechanisms of inflammation have been elucidated. Damage-associated molecular patterns (DAMPs) released from cells damaged by ischemia or injury, or pathogen-associated molecular patterns (PAMPs) released by pathogens, are recognized by internal cell receptors or cell surface receptors, leading to the synthesis of inflammatory proteins including proinflammatory/anti-inflammatory cytokines, which are then secreted by the cells. These cytokines stimulate the production of additional cytokines, causing a vicious circle of inflammatory responses, such as innate immune responses by macrophages. In addition, lymphocytes activated by these cytokines stimulate adaptive immunity. During liver transplantation, the general preoperative condition of the patient and surgical invasiveness are associated with organ failure and ischemia-reperfusion injury, which can lead to transplant rejection. It has been suggested that progressive immunodeficiency and organ failure as a result of pre-transplant cirrhosis are associated with postoperative multiple organ failure and death, and that elevated intraoperative DAMPs correlate with organ failure. Furthermore, DAMP receptors and inflammatory cytokines are increased by ischemia-reperfusion injury, indicating its role in promoting innate and adaptive immunity. In addition, inflammatory signals induced by postoperative infections are similar to those induced by ischemia-reperfusion injury and rejection, indicating that pathogen-derived inflammation can also lead to rejection. In summary, most complications in liver transplantation can be explained in a unified manner by abnormal inflammatory responses; therefore, controlling inflammation might be of benefit for the struggle of safe and effective liver transplantation.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85015223","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}

引用次数: 0

Study the Relation between Blood Ammonia Level and Esophageal Varices in Egyptian Patients with Liver Cirrhosis 埃及肝硬化患者血氨水平与食管静脉曲张的关系研究

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI: 10.21614/sgo-ec-348

E. A. Abd ELatti, Ahmed Ibrahim Mohammed, Walid Mouhamed Fathy, Abdel-Naser Abdel-Aty Gad Allah

引用次数: 0

Liver Transplantation and Surgery in the Management of Hepatocellular Carcinoma 肝移植和手术治疗肝细胞癌

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI: 10.21614/SGO-26-320

M. Malágo, D. Raptis, C. Imber, Giovanni Dalla Serra, O. Kornasiewicz

{"title":"Liver Transplantation and Surgery in the Management of Hepatocellular Carcinoma","authors":"M. Malágo, D. Raptis, C. Imber, Giovanni Dalla Serra, O. Kornasiewicz","doi":"10.21614/SGO-26-320","DOIUrl":"https://doi.org/10.21614/SGO-26-320","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the second cause of cancer–related deaths worldwide constitutes a major global health problem. Although our understanding of the molecular pathogenesis of hepatocellular HCC has improved, detected driver mutations are not yet sufficiently reliable therapeutic targets. The modern management of HCC is conceived only within multidisciplinary schemes. Current systemic therapies are not curative and surgical treatments remain the only potential curative treatments for selected patients with early stage HCC. The role of parenchyma sparing liver resection for appropriately selected patients may vary in different environments according to organ availability,and liver resection remains a reliable curative method for HCC. Meta-analyses have shown that clinical outcomes of surgical resection are superior to ablative treatments in early stage HCC. Liver transplantation is still the standard treatment for patients with early stage HCC. Lately the Milan Criteria are considered too restrictive, still recognizing that the extension of transplantation criteria beyond Milano criteria increases the risk of HCC recurrence. Resection, ablation, transarterial embolization and trans-arterial radiation are commonly applied to bridge patients to transplant. Despite enormous advances in the therapy of HCC treatments at present, there are currently no genuine breakthroughs for patients with HCC. The Clinical Trials Planning Meeting (CTPM) in HCC convened by the American Society of Clinical Oncology identified the key knowledge gaps in HCC and define clinical research priorities. Major improvements in survival provided by multimodal treatments witnessed in other cancers are not yet available for HCC because effective systemic treatment modalities for HCC are still lacking. Integration of bio-genetic tumor information into current tested treatment schemes and truly multimodal surgery-based treatment schemes will enable the recruitment of less selected patients in larger numbers to curative treatments.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84629768","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}

引用次数: 0

Unusual Presentation of a Gastrointestinal Tumor in Excluded Stomach - the Need to Think About the Hidden Enemy 胃肠肿瘤的不寻常表现-需要考虑隐藏的敌人

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI: 10.21614/sgo-26-4-323

T. Guedes, D. Ferreira, José Ricardo Brandão, Jose Ramon Vizcaino, I. Pedroto

{"title":"Unusual Presentation of a Gastrointestinal Tumor in Excluded Stomach - the Need to Think About the Hidden Enemy","authors":"T. Guedes, D. Ferreira, José Ricardo Brandão, Jose Ramon Vizcaino, I. Pedroto","doi":"10.21614/sgo-26-4-323","DOIUrl":"https://doi.org/10.21614/sgo-26-4-323","url":null,"abstract":"Obesity and its surgical treatment have been increasing in the last decade. Roux-en-Y gastric bypass (RYGB) is one of the most common procedures performed, resulting in an excluded stomach that can be the home of pre- and postoperative pathology. We present a case report of a 52 years-old man with melena and refractory anemia 2 years after RYGB. Although a possible etiology was found through esophagogastroduodenoscopy, the persistence of anemia determined the search for other causes. Additional abdominal CT revealed a tumoral mass in the excluded stomach with subsequent biopsy findings compatible with a gastrointestinal stromal tumor (GIST). Neoadjuvant imatinib therapy and surgery werewas performed confirming the diagnosis and showing GIST ulcerating the mucosa of the excluded stomach. After surgery, imatinib treatment was restarted and maintained so far with no recurrence of anemia. Malignancy of excluded stomach are frequently of epithelial origin and, to our knowledge, GIST occurrence is a very rare finding on an excluded stomach. This highlights the importance of considering the occurrence of hidden pathology in the excluded stomach, as well as the need for a high-qualityhigh quality EGD in pre-bariatric surgery evaluation.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81714378","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}

引用次数: 0

Emergency Laparoscopic Cholecystectomy with Low-Pressure Pneumo-Peritoneum in Cardiopulmonary Risk Patients: Fundus-Calot Cholecystectomy versus Calot First Cholecystectomy. Randomized Controlled Trial 急诊腹腔镜胆囊切除术加低压腹膜肺治疗心肺危险患者:胃底胆囊切除术vs胃底胆囊切除术。随机对照试验

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI: 10.21614/sgo-ec-370

T. Habeeb, Mahmoud Abdouyassin, Fady Mehaney Habib, Muhammad A. Baghdadi

引用次数: 0

Correlation of HIV Status to Non-HPV Associated Benign Surgical Perianal Pathologies HIV状态与非hpv相关良性手术肛周病变的相关性

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI: 10.21614/sgo-ec-221

M. Motsumi, John Thato Tlhakanelo

引用次数: 0

Preoperative Clinical and Radiological Variables for Prediction of Difficult Laparoscopic Cholecystectomy 预测腹腔镜胆囊切除术困难的术前临床和影像学指标

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI: 10.21614/sgo-26-4-386

S. Elgarf, Tamer M. Elmahdy, M. Ghazaly, A. Swelam

{"title":"Preoperative Clinical and Radiological Variables for Prediction of Difficult Laparoscopic Cholecystectomy","authors":"S. Elgarf, Tamer M. Elmahdy, M. Ghazaly, A. Swelam","doi":"10.21614/sgo-26-4-386","DOIUrl":"https://doi.org/10.21614/sgo-26-4-386","url":null,"abstract":"Introduction: Laparoscopic cholecystectomy (LC) has replaced open technique as the main surgical intervention in the treatment of gall bladder stones. There are different clinical and radiological predictors that are indicators for technically difficult LC. Aim of the work: The aim of this study was to identify the clinical and radiological variables associated with difficult LC. Methods: During the period from March 2018 to March 2021, 452 adult patients who presented with symptomatic gall bladder stones underwent LC. Different clinical and radiological data were collected as: abdominal scar, palpable gall bladder, previous hospitalization, history of ERCP, total leucocyte count, thickness of the gall bladder wall, peri-cholecystic collection, solitary or multiple gall bladder stones, impacted stone and diameter of the CBD. Results: Age of 50 years or over (P value 0.001), male gender (P value 0.001), previous hospital admission (P value 0.001), impacted stones (P value 0.003), and leukocytosis (P value 0.031) were found statistically significant with area under ROC curve is 0.814 with 95 % confidence interval. Conclusion: These preoperative risk factors; old age, male gender, previous hospitalization for biliary problem, impacted stone, and leukocytosis could potentially predict difficult LC, and give surgeons and their assistants the chance to predict the risk of complications intraoperatively and the possibility to convert the maneuver to a bail-out one.","PeriodicalId":22101,"journal":{"name":"Surgery, Gastroenterology and Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73166326","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}

引用次数: 0