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 role of C-reactive protein ratio in predicting mortality in patients with Fournier gangrene
Ismail Cem ERAY ; Kubilay DALCI ; Serdar GUMUS ; Orcun YALAV ; Ahmet Gokhan SARITAS ; Asli BOZ ; Ahmet RENCUZOGULLARI
Annals of Coloproctology 2023;39(3):223-230
Purpose:
This study aimed to determine the C-reactive protein (CRP) ratio for the survival of patients with Fournier gangrene (FG).
Methods:
Fifty-two patients with FG between January 2011 and September 2018 were retrospectively analyzed. Data on clinical presentation, Fournier Gangrene Severity Index (FGSI), CRP ratio, management, and outcome were analyzed. The CRP ratio was calculated as preoperative CRP/postoperative CRP value that measured 48 hours after surgical intervention. Possible alternative cutoff points for the FGSI and CRP were determined by receiver operating characteristic (ROC) analyses. The risk factors related to the prognosis were evaluated by univariate and multivariable logistic regression analyses.
Results:
The mean CRP ratios were 6.7±6.6 in the survivor group and 1.2±0.8 in the nonsurvivor group (P=0.001). FGSI was significantly higher in the non-survivor group compared to survivor group (8.5±2.5 vs. 3.5±2.2, P=0.001). There was a negative correlation between FGSI and CRP ratio (r=–0.51). ROC analysis determined the cutoff value as 1.78 for CRP (sensitivity, 86%; specificity, 82%; area under the ROC curve, 0.90) to predict death. The incidence of death for patients with CRP ratio of ≤1.78 increased 26.7 fold for those with CRP ratio of >1.78 (95% confidence interval [CI], 4.8–146.5; P=0.001). In the multivariable logistic regression model, CRP ratio (odds ratio [OR], 10.3; 95% CI, 1.5–72.2; P=0.019) and FGSI (OR, 17.8; 95% CI, 2.6–121.1; P=0.003) were independent risk factors for death.
Conclusion
The CRP ratio is a simple method to use to predict mortality in FG.