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Safer intestinal invagination for a solid pancre-atico-jejunal anastomosis in presence of a soft texture pancreatic remnant and non-dilated duct

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Hepatobiliary & Pancreatic Diseases International 2016年第3期15卷 324-328页

作者： francesco giudici benedetta pesi daniela zambonin stefano scaringi paolo bechi giacomo batignani Author Affiliations:Unit of Surgery Department of Surgery and Translational MedicineUniversity of Florence Medical SchoolCareggi University HospitalFlorenceItaly

Pancreatico-jejunal anastomosis after pancreato- duodenectomy still represents the Achilles＇ heel of the proce- dure： the failure of this anastomosis is relatively common and it is the main cause of post-operative morbidity and mortality. Studies have described different reconstruction strategies for the control of the development of post-operative pancreatic fistula, but the strategy to obtain a safer pancreatico-jejunal anastomosis is still far from satisfaction. We report a novel variation of the invagination technique based on preliminary clinical experience in 8 patients who underwent pancreatico- jejunal anastomosis after pancreatoduodenectomy in our hepatobiliopancreatic center from 2008 to 2014. The varia- tion could obtain a safer intestinal invagination for a solid pancreatico-jejunal anastomosis even in the presence of soft pancreatic remnant.

关键词： pancreatico-jejunal anastomosis anastomosis pancreatoduodenectomy invagination novel variation

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Vascular Invasion, Satellite Nodules and Absence of Tumor Capsule Strongly Correlate with Disease-Free Survival and Long-Term Outcome in Patients Resected for Hepatocellular Carcinoma

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Journal of Cancer Therapy 2014年第14期5卷 1344-1353页

作者： Benedetta Pesi Luca Moraldi daniela zambonin Francesco Giudici Tiziana Cavalli Rami Addasi Francesca Leo Stefano Scaringi Giacomo Batignani Gastro-Intestinal Surgery Unit Department of Surgery and Translational Medicine Careggi University Hospital Florence Italy

Background: Hepatocellular carcinoma (HCC) is one of the most common cancer in the world. Liver resection (LR) is the most used therapy in well compensated liver cirrhosis and maybe used as a first-line treatment. Aim of the study is to evaluate survival rates in patients who underwent LR for HCC and to identify risk factors able to influence the prognosis. Material/Method: A retrospective study was carried out in 115 patients whounderwent LR for HCC. We evaluated overall and disease-free survival rates at 1, 3 and 5years (y) and a series of variables included: type of resection, clamping, blood loss, transfusions, tumor size, presence of capsule, satellite nodules and vascular invasion. Results: The 1-, 3-, 5-y survival rates were 90.2%, 67% and 52.7%, and disease-free survival rates were 75.3%, 44.7% and 28.4%, respectively. We have found presence/ absence of capsulated tumor (p = 0.05), satellite nodules (p = 0.004) and vascular invasion (p = 0.001) as factors able to influence the overall survival and the disease-free survival (p = 0.04 for capsulated tumor, p = 0.01 for satellite nodules and p = 0.006 for vascular invasion). Conclusion: LR is the best therapeutic option for HCC when liver transplantation is contraindicated, with good survival rates. Presence of capsule, satellite nodules and vascular invasion are the most important factors able to influence the prognosis.

关键词： Liver Resection Hepatocellular Carcinoma Prognostic Factors Vascular Invasion Satellite Nodules

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Multiplex gene expression profile in inflamed mucosa of patients with Crohn’s disease ileal localization: A pilot study

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World Journal of Clinical Cases 2019年第17期7卷 2463-2476页

作者： Francesco Giudici Letizia Lombardelli Edda Russo Tiziana Cavalli daniela zambonin Federica Logiodice Ornela Kullolli Lamberto Giusti Tatiana Bargellini Marilena Fazi Livia Biancone Stefano Scaringi Ann Maria Clemente Eloisa Perissi Giovanni Delfino Maria G Torcia Ferdinando Ficari Francesco Tonelli Marie-Pierre Piccinni Cecilia Malentacchi Department of Experimental and Clinical Medicine University of FirenzeFirenze 50134Italy Dipartimento Chirurgico Ortopedico Ospedale Carlo Poma di MantovaFirenze 50134Italy Department of Experimental and Clinical Biomedical Sciences “Mario Serio” University of FirenzeFirenze 50134Italy Surgical Unit Department of Surgery and Translational MedicineUniversity of FirenzeFirenze 50134Italy Department of Internal Medicine University of Roma Tor VergataRoma 00133Italy

BACKGROUND Crohn’s disease (CD) is a complex disorder resulting from the interaction of genetic,environmental,and microbial *** pathogenic process may potentially affect any segment of the gastrointestinal tract,but a selective location in the terminal ileum was reported in 50% of *** To characterize clinical sub-phenotypes (colonic and/or ileal) within the same disease,in order to identify new therapeutic *** 14 consecutive patients undergoing surgery for ileal CD were recruited for this *** blood samples from each patient were collected and the main polymorphisms of the gene Card15/Nod2 (R702W,G908R,and 1007fs) were analyzed in each *** addition,tissue samples were taken from both the tract affected by CD and from the apparently healthy and disease-free margins (internal controls).We used a multiplex gene assay in specimens obtained from patients with ileal localization of CD to evaluate the simultaneous expression of 24 genes involved in the pathogenesis of the *** also processed surgery gut samples with routine light microscopy (LM) and transmission electron microscopy (TEM) techniques to evaluate their structural and ultrastructural *** We found a significant increase of Th17 (IL17A and IL17F,IL 23R and CCR6) and Th1 (IFN-γ) gene expression in inflamed mucosa compared to non-inflamed sites of 14 CD ***4 and HAMP,two genes coding for antimicrobial peptides,were also strongly activated in inflamed ileal mucosa,suggesting the overwhelming stimulation of epithelial cells by commensal ***-γ and CCR6 were more expressed in inflamed mucosa of CD patients with ileal localization compared with patients with colonic localization suggesting a more aggressive inflammation process in this *** analysis of the epithelial lining of Lieberkün crypts disclosed enhanced release activity from goblet mucocytes,whereas the lamina propria contained numerous cells pertaining to vari

关键词： Crohn's disease Ileum Colon Messenger ribonucleic acid Th1/Th17 Microbiota Inflammation

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