1.The usefulness of drainage-internal capitonnage with/ without selective bile duct repair technique for liver hydatid cyst
Atılgan Tolga AKCAM ; Ahmet Gokhan SARITAS ; Kubilay DALCI ; Abdullah ULKU
Annals of Surgical Treatment and Research 2021;100(5):270-275
Purpose:
The aim of the present study is to describe the cavity-reducing internal capitonnage technique that we used for the surgical therapy of liver hydatid cyst, and contribute to the literature by presenting the short- and long-term outcomes of the patients who were operated on with this technique.
Methods:
A drainage and internal capitonnage technique was performed on 12 cases due to liver hydatid cyst in our clinic between January 2016 and December 2019.
Results:
The mean age of cases was 36.25 ± 12.5 years, with 7 females and 5 males. All cases had pain in the right upper quadrant, and a sense of fullness in 5 cases. None of the cases had ruptured cysts, jaundice, or other clinical manifestations. The preoperative laboratory findings were normal in 8 cases. Intraoperative biliary-cyst communication was demonstrated in 8 cases (66.7%). Cases were followed up for a mean duration of 38.1 months (range, 24–88 months).
Conclusion
The drainage/internal capitonnage with/without selective bile duct repair is a technique that can be performed with very low morbidity and mortality rates in experienced hands, especially for centrally located hydatid cysts.
2.The usefulness of drainage-internal capitonnage with/ without selective bile duct repair technique for liver hydatid cyst
Atılgan Tolga AKCAM ; Ahmet Gokhan SARITAS ; Kubilay DALCI ; Abdullah ULKU
Annals of Surgical Treatment and Research 2021;100(5):270-275
Purpose:
The aim of the present study is to describe the cavity-reducing internal capitonnage technique that we used for the surgical therapy of liver hydatid cyst, and contribute to the literature by presenting the short- and long-term outcomes of the patients who were operated on with this technique.
Methods:
A drainage and internal capitonnage technique was performed on 12 cases due to liver hydatid cyst in our clinic between January 2016 and December 2019.
Results:
The mean age of cases was 36.25 ± 12.5 years, with 7 females and 5 males. All cases had pain in the right upper quadrant, and a sense of fullness in 5 cases. None of the cases had ruptured cysts, jaundice, or other clinical manifestations. The preoperative laboratory findings were normal in 8 cases. Intraoperative biliary-cyst communication was demonstrated in 8 cases (66.7%). Cases were followed up for a mean duration of 38.1 months (range, 24–88 months).
Conclusion
The drainage/internal capitonnage with/without selective bile duct repair is a technique that can be performed with very low morbidity and mortality rates in experienced hands, especially for centrally located hydatid cysts.
3.The efficacy of 18F-FDG PET/CT in the preoperative evaluation of pancreatic lesions
Atilgan Tolga AKCAM ; Zafer TEKE ; Ahmet Gokhan SARITAS ; Abdullah ULKU ; Isa Burak GUNEY ; Ahmet RENCUZOGULLARI
Annals of Surgical Treatment and Research 2020;98(4):184-189
Purpose:
Since the treatment strategy for benign and malignant pancreatic lesions differ, we aimed to evaluate the clinical value of PET/CT in the diagnosis and management of pancreatic lesions.
Methods:
Ninety patients who had a histologically confirmed pancreatic lesion were studied. Receiver operating characteristic (ROC) curve analysis was used to investigate the ability of PET/CT to differentiate malignant lesions from benign tumors.
Results:
The malignant and benign groups comprised 64 and 26 patients, respectively. Despite the similarity in the size of primary tumors (P = 0.588), the mean maximum standardized uptake values (SUVmax) obtained from PET/CT imaging were significantly higher in malignant lesions (9.36 ± 5.9) than those of benign tumors (1.04 ± 2.6, P < 0.001). ROC analysis showed that the optimal SUVmax cutoff value for differentiating malignant lesions (to an accuracy of 91%; 95% confidence interval, 83%–98%) from benign tumors was 3.9 (sensitivity, 92.2%; specificity, 84.6%).
Conclusion
PET/CT evaluation of pancreatic lesions confers advantages including fine assessment of malignant potential with high sensitivity and accuracy using a threshold SUVmax value of 3.9.
4.Xanthogranulomatous cholecystitis: a rare gallbladder pathology from a single-center perspective
Ahmet Gokhan SARITAS ; Mehmet Onur GUL ; Zafer TEKE ; Abdullah ULKU ; Ahmet RENCUZOGULLARI ; Ishak AYDIN ; Atilgan Tolga AKCAM
Annals of Surgical Treatment and Research 2020;99(4):230-237
Purpose:
The aim of this study was to review patients with xanthogranulomatous cholecystitis (XGC).
Methods:
A total of 79 patients diagnosed with XGC were included in the study. The criteria for XGC in the pathology specimens were the presence of histiocytes, cholesterol deposits, lipids, and focal or widespread wall enlargement.
Results:
Patients were diagnosed with XGC, of which 52 (65.8%) were male and 27 (34.2%) were female, creating a male-to-female ratio of 2:1. The mean age was 65.8 ± 14.3 years (range, 36–97 years). The most common presenting symptom was abdominal pain (63.3%), and the least common presenting symptom was jaundice (8.9%). Of the total, 25 patients were found to have pathological conditions with the potential to obstruct the bile duct or to slow bile flow.A frozen section examination was performed on 20 patients due to suspicion of a tumor by intraoperative macroscopic examination. However, no malignancy was detected in the cases who underwent a frozen section examination. An increase in wall thickness of the gallbladder was observed in 81.6% (n = 31) of the patients on computed tomography scans and in 81.8% (n = 18) of the patients on magnetic resonance imaging scans in which possible tumor lesions were reported, but no tumor was detected.
Conclusion
It is difficult to diagnose XGC either preoperatively or intraoperatively, and further imaging methods are needed in the preoperative period other than ultrasonography. However, a definitive diagnosis depends exclusively on pathologic examination.