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Management of mucinous cystic neoplasms of the pancreas

World Journal of Gastroenterology 2010年第45期16卷 5682-5692页

作者： Mario Testini Angela Gurrado Germana Lissidini Pietro Venezia Luigi Greco giuseppe piccinni Unit of Endocrine Digestive and Emergency SurgeryDepartment of Biomedical Sciences and Human OncologySection of General and Oncologic SurgeryUniversity Medical School of Bari70124 BariItaly Department of Emergency and Organ Transplantation University Medical School of Bari70124 BariItaly

The purpose of this study was to investigate the actual management of mucinous cystic neoplasm (MCN) of the pancreas. A systematic review was performed in December 2009 by consulting PubMed MEDLINE for publications and matching the "pancreatic mucinous cystic neoplasm", "pancreatic mucinous cystic tumour", "pancreatic mucinous cystic mass", "pancreatic cyst", and "pancreatic cystic neoplasm" to identify English language articles describing the diagnosis and treatment of the mucinous cystic neoplasm of the pancreas. In total, 16 322 references ranging from January 1969 to December 2009 were analysed and 77 articles were identified. No articles published before 1996 were selected because MCNs were not previously considered to be a completely autonomous disease. Definition, epidemiology, anatomopathological findings, clinical presentation, preoperative evaluation, treatment and prognosis were reviewed. MCNs are pancreatic mucinproducing cysts with a distinctive ovarian-type stroma localized in the body-tail of the gland and occurring in middle-aged females. The majority of MCNs are slow growing and asymptomatic. The prevalence of invasive carcinoma varies between 6% and 55%. Preoperative diagnosis depends on a combination of clinical features, tumor markers, computed tomography (CT), magnetic resonance imaging, endoscopic ultrasound with cyst fluid analysis, and positron emission tomography-CT. Surgery is indicated for all MCNs.

关键词： Pancreatic cystic lesion Pancreatic mucinous cystic neoplasm Pancreatic mucin-producing cysts Pancreatic cystic neoplasm Pancreatic ovarian-type stroma

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Definitive palliation for neoplastic colonic obstruction using enteral stents:Personal case-series with literature review

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World Journal of Gastroenterology 2004年第5期10卷 758-764页

作者： giuseppe piccinni Anna Angrisano Mario Testini G.Martino Bonomo Section of General Surgery Vascular Surgery and Clinical OncologyDepartment of Applications in Surgery of Innovative TechnologiesUniversity of Bari-School of Medicine-BariItaly

Acute colonic obstruction due to malignancies is an emergency that requires surgical *** patients or inoperable tumors require intestinal decompression that is a simple colostomy in almost all ***“manoeuvre” leads the patient to a percentage of moRality/morbidity and to a bad quality of life due to acceptance of *** introduction of enteral metal stent inserted endoscopically has,in our opinion,provided a new way to obtaining the definitive palliation of inoperable colo-rectal cancer with a simple *** reported our case-series and we analyzed the current literature and costs of treatments.

关键词： Stents Aged Aged, 80 and over Colonic Neoplasms Endoscopy Female Humans Intestinal Obstruction Male Palliative Care

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Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

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World Journal of Gastroenterology 2003年第10期9卷 2338-2340页

作者： Mario Testini Piero Portincasa giuseppe piccinni Germana Lissidini Fabio Pellegrini Luigi Greco Section of General Surgery and Vascular Surgery and Clinical Oncology Department of Applications in Surgery of Innovative Technologies(DACTI)University Medical SchoolBariItaly Section of Internal Medicine Department of Internal Medicine and Public Medicine(DIMIMP)University Medical SchoolBariItaly Department of Clinical Pharmacology and Epidemiology Pharmacological Research InstituteConsortium"Mario Negri"SouthMaria Imbaro(L'Aquila)Italy Section of General Surgery Department of Emergency and Organ Transplantations(DETO)University Medical SchoolBailItaly

AIM:To evaluate the main factors associated with mortality in patients undergoing surgery for perforated peptic ulcer referred to an academic department of general surgery in a large southern Italian city. METHODS:One hundred and forty-nine consecutive patients (M:F ratio=110:39,mean age 52 yrs,range 16-95) with peptic ulcer disease were investigated for clinical history (including age,sex,previous history of peptic ulcer,associated diseases,delayed abdominal surgery,ulcer site,operation type,shock on admission,postoperative general complications, and intra-abdominal and/or wound infections),serum analyses and radiological findings. RESULTS:The overall mortality rate was 4.0%.Among all factors,an age above 65 years,one or more associated diseases,delayed abdominal surgery,shock on admission, postoperative abdominal complications and/or wound infections,were significantly associated (x^2) with increased mortality in patients undergoing surgery (0.0001

关键词： Academic Medical Centers numerical data Acute Disease Adolescent Adult Aged Aged, 80 and over Emergency Medical Services Female Humans Italy Male Middle Aged Peptic Ulcer Perforation Postoperative Complications Referral and Consultation Risk Factors Shock Time Factors

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