We found that elevated serum CRP levels support surgeon's clinical diagnosis. We recommend CRP measurement as a routine laboratory test in patients with suspected diagnosis of acute appendicitis.
Unacceptably high false negative and positive rates decrease the accuracy of the serum IL-6 test for appendicitis. Serum IL-6 measurement is not of benefit in increasing the accuracy of the diagnosis of appendicitis. Serum IL-6 results are not useful for preventing negative laparotomies in the majority of patients with right iliac fossa pain.
Hydatid disease is one of the world's most important health problems. Although several conservative approaches have been used for the management of this condition, surgery remains the ideal choice in most of the cases. Videolaparoscopic approach can safely be applied for the management of liver hydatid cysts if several precautions are undertaken. In this study, we present two liver hydatid cyst cases successfully treated with partial cystectomy and omentoplasty using videolaparoscopic approach.
The great majority of gallbladder carcinoma is associated with gallstones. This cancer is generally diagnosed in advanced stages, and the prognosis is very poor. In this study we analysed retrospectively 3119 patients with cholelithiasis alone, and 35 patients with gallbladder cancer. Thirty-three of 35 cancer cases (94%) were associated with gallstones. Cancer rate was 1% in patients with cholelithiasis. Mean age was significantly higher in patients with gallbladder cancer than in those with cholelithiasis alone, 66.5 and 53.3 respectively (p < 0.0001). Sixty four percent of cancer cases were between 61-70 years of age, and the rate of carcinoma was 2.8% in this group (p < 0.001). The cancer rate was found to be 0.29% inpatients under 60 years of age, and 2.56% in those over 60 years (p < 0.001). According to Nevin's classification, 88% of cancer cases were found in advanced stages. Seventeen (52%) cases were diagnosed preoperatively. Ninety four percent of patients with preoperative diagnosis were in advanced stages compared with 31% of patients with incidental diagnosis (p = 0.0002). Patients with early stages carcinoma were alive and free of disease 58 months after operation. Average survival was only 9.5 months in patients with advanced cancer. We conclude that the incidence of gallbladder carcinoma increases significantly in patients over 60 years of age. Today preoperative early diagnosis is almost impossible, and long-term survival is possible only for early cases incidentally discovered at postoperative pathological examination of removed gallbladders for gallstone disease. Radical surgery has not provided long-term survival. We recommend close follow-up of patients with cholelithiasis, and enlargement of indication for cholecystectomy in a selective manner, considering some criteria in patients older than 55 years of age who are known with long-standing cholelithiasis.
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.