Background: Proper patient selection for most appropriate treatment option for hepatic hydatid is crucial to ensure successful treatment outcome. Chemotherapy, newer approaches, like PAIR procedure, (puncture, aspiration, injection and reaspiration) laparoscopy are available. As the indications for these approaches are restricted, surgery remains the key treatment strategy with hope for complete cure. Radical surgical excision coupled with chemotherapy and long-term aggressive chemotherapy for partially resected ensures lowest morbidity and mortality. Methods: This cross sectional observational study of 15-year single-institution experience, intended to further validate different surgical procedures in management of hydatid disease of liver and its outcome. Patients were randomly selected irrespective of their age, sex and mode of presentation. Different preferred surgical treatment modalities, perioperative complications, recurrences, and length of hospital stay were retrospectively analyzed. Result: The study was carried out on 79 Bangladeshi patients diagnosed hepatic hydatidosis, treated surgically from January 2002 to December 2017 in BIRDEM General Hospital. Among them was no anastomotic leakage or mortality in the immediate postoperative period in our series. Conclusion: This study revealed, proper case selection and consideration of risks-benefits, indicationscontraindications for each case of Hydatid cyst of liver, for making a decision for type and timing of surgery is key to successful outcome. Surgery is the mainstay of treatment strategy. Radical surgery is key to effective and successful outcome, ensures better quality of life and prevents recurrence of the disease. Journal of Surgical Sciences (2018) Vol. 22 (2) : 118-124
Conclusion:Perioperative nutritional management appears to contribute to early induction and increase of completion rate of adjuvant chemotherapy. Combining nutritional management with adjuvant chemotherapy may enable to improve the treatment outcome in pancreatic cancer.
In the digestive system, mesenchymal origin of tumors is quite rare; in general, they are recognized as gastrointestinal stromal tumors (GISTs). The incidence of GISTs is very low (2 in 100,000), while jejunal GISTs are extremely rare, accounting for 0.1–3% of all gastrointestinal (GI) tumors. Small intestinal GISTs are the second most common (25%) site in the GI tract, usually occurring in the duodenum. We present the case of a 62-year-old Bangladeshi female with a history of GI bleeding 3 years earlier; the cause of the bleeding had not been found despite extensive investigations. In the meantime, the patient had developed occasional abdominal pain and lumpy feelings in the right side of the abdomen without any GI bleeding. Exploratory laparotomy was carried out in view of a small intestinal mesenteric mass in a computed tomography scan. On midline incision there was a 6 × 6 cm mass in the antimesenteric border of the jejunum approximately 30 cm from the duodenojejunal flexure, which was resected followed by anastomosis. The presentation of GISTs ranges from asymptomatic to mild abdominal pain and mass (5–50%) and mechanical obstruction (5%) as well as hemorrhage – perforation having rarely been reported (0.8%) – making the diagnosis difficult. Exophytic growth of these tumors has been noted in 18–30% of cases. In view of intermediate risk of malignancy, the patient was started with adjuvant imatinib 400 mg once daily due to probability of disease recurrence (24%).
Background: Mirizzi syndrome is a condition, difficult to diagnose pre-operatively and treat, represent a particular challenge for hepatobiliary surgeons. Furthermore, it increases the risk of intra-operative biliary injury, particularly during laparoscopic cholecystectomy. The aims of this study were to point out some particular aspect of diagnosis and treatment of this condition that will be helpful for the surgeons. Methods:We retrospectively reviewed all records of the patients, surgically treated for Mirizzi syndrome from Patients' presentation, diagnostic methods, treatment and complications were recorded.Results: During the study period, a total of 1320 cholecystectomy were performed, out of which 50 patients were diagnosed with Mirizzi syndrome, representing an incidence rate of 3.78%. Male to female ratio was 0.72:1 and mean age was 54.14 years. When we analyzed the main symptoms in the clinical debut, we found that common features were jaundice (31, 62%), cholangitis (20, 40%) and abdominal pain (22, 44%). Roux en Y hepaticojejunostomy was the treatment of choice and subtotal cholecystectomy were done for 7 cases and laparoscopic cholecystectomy for 2 cases. Mean hospital stay was 4.8±2.9 days. There was no post-operative mortality. Two cases of biliary fistula resolved with conservative management and another case required percutaneous treatment for resolution of an intraperitoneal postoperative collection. Conclusion:Mirizzi syndrome continues to be a disease of difficult diagnosis and treatment. General surgeons without long experience in hepatobiliary surgery should refer the patient to a specialized hepatobiliary surgical center. In most of the cases biliary reconstruction is inevitable. It is important for the surgeons to know the disease and possible intra-operative challenging situations.
Solid pseudopapillary tumor of pancreas is a rare tumor almost exclusively affecting the young female and accounts for <1% of all pancreatic tumors. Most hypothesis suggests that the tumor arises from embryonic pleuripotent stem cells. Although mostly benign in nature, the tumor may show malignant potentials and the patient may present with hepatic, omental or other meatstasis. High index of suspicion is the key for early dianosis. Good quality imaging (USG and CT scan) & FNAC are necessary for proper evaluation of the lesion. Peroperative frozen section biopsy may be necessary to ascertain its malignant potential. Radical resection is the best modality of treatment for achieving curative results and a better long-term survival. We are reporting our experience of treating a case of solid pseudopapillary tumor of pancreas in BIRDEM Hospital. Birdem Med J 2013; 3(1): 54-58 DOI: http://dx.doi.org/10.3329/birdem.v3i1.17129
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.