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Gallbladder polyps: Factors affecting surgical decision

World Journal of Gastroenterology 2013年第28期19卷 4526-4530页

作者： Pinar Sarkut Sadik Kilicturgay Ali Ozer Ersin Ozturk tuncay yilmazlar Department of General Surgery Uludag University School of Medicine Gorukle 16059 Bursa Turke

AIM: To determine the factors affecting the decision to perform surgery, and the efficiency of ultrasonography (USG) in detecting gallbladder polyps (GP). METHODS: Data for 138 patients who underwent cholecystectomy between 1996 and 2012 in our clinic with a diagnosis of GP were retrospectively analyzed. Demographic data, clinical presentation, principal symptoms, ultrasonographic and histopathological findings were evaluated. Patients were evaluated in individual groups according to the age of the patients (older or younger than 50 years old) and polyp size (bigger or smaller than 10 mm) and characteristics of the polyps (pseudopolyp or real polyps). χ 2 tests were used for the statistical evaluation of the data. RESULTS: The median age was 50 (26-85) years and 91 of patients were female. Of 138 patients who underwent cholecystectomy with GP diagnosis, only 99 had a histopathologically defined polyp; 77 of them had pseudopolyps and 22 had true polyps. Twenty-one patients had adenocarcinoma. Of these 21 patients, 11 were male, their median age was 61 (40-85) years and all malignant polyps had diameters > 10 mm (P 10 mm, 22 had true polyps. The sensitivity of USG was 84.6% for polyps with diameters > 10 mm (P 10 mm.

关键词： Gallbladder Polyps Ultrasound Cholecystectomy Malignancy

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Management of hepatorenal syndrome

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World Journal of Nephrology 2015年第2期4卷 277-286页

作者： Halit Ziya Dundar tuncay yilmazlar Department of General Surgery Faculty of MedicineUludag University

Hepatorenal syndrome （HRS） is defned as development of renal dysfunction in patients with chronic liver diseases due to decreased effective arterial blood volume. It is the most severe complication of cirrhosis because of its very poor prognosis. In spite of several hypotheses and research, the pathogenesis of HRS is still poorly understood. The onset of HRS is a progressive process rather than a suddenly arising phenomenon. Since there are no specifc tests for HRS diagnosis, it is diagnosed by the exclusion of other causes of acute kidney injury in cirrhotic patients. There are two types of HRS with different characteristics and prognostics. Type 1 HRS is characterized by a sudden onset acute renal failure and a rapid deterioration ofother organ functions. It may develop spontaneously or be due to some precipitating factors. Type 2 HRS is characterized by slow and progressive worsening of renal functions due to cirrhosis and portal hypertension and it is accompanied by refractory ascites. The only definitive treatment for both Type 1 and Type 2 HRS is liver transplantation. The most suitable bridge treatment or treatment for patients who are not eligible for transplantation is a combination of terlipressin and albumin. For the same purpose, it is possible to try hemodialysis or renal replacement therapies in the form of continuous veno-venous hemofiltration. Artificial hepatic support systems are important for patients who do not respond to medical *** intrahepatic portosystemic shunt may be considered as a treatment modality for unresponsive patients to medical treatment. The main goal of clinical surveillance in a cirrhotic patient is prevention of HRS before it develops. The aim of this article is to provide an updated review about the physiopathology of HRS and its treatment.

关键词： Hepatorenal syndrome Cirrhosis Renal failure Vasoconstrictors Transplantation

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Anti-inflammatory efficiency of levobupivacaine in an experimental colitis model

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World Journal of Gastroenterology 2010年第20期16卷 2537-2541页

作者： Ugur Duman Aysun yilmazlar Ersin Ozturk Sibel Aker Emre Sarandol tuncay yilmazlar Department of General Surgery Uludag University School of Medicine16069 BursaTurkey Department of Anesthesiology and Reanimation Uludag University School of Medicine16069 BursaTurkey Department of Pathology Uludag University School of Medicine16069 BursaTurkey Department of Biochemistry Uludag University School of Medicine16069 BursaTurkey

AIM:To investigate the efficiency of levobupivacaine in treating experimentally induced colitis in ***:Colitis was induced by trinitrobenzene sulfonic acid and ethanol in 30 rats under general anesthesia,and 10 rats were used as a sham *** to induction of colitis,rats were divided into three groups;budesonide group received 0.1 mg/kg budesonide,levobupivacaine group received 10 mg/kg levobupivacaine and saline group received 1 mL saline solution via rectal route for 7 *** the sham group,only routine rectal catheterization was performed without use of any *** the end of 7 d,laparotomy and total colectomy were performed for histopathological ex-amination in all rats and blood samples were drawn for measurement of tumor necrosis factor(TNF)-αand interleukin(IL)-6 following cardiac *** and microscopic evaluations of the specimens were performed by a pathologist blinded to group assignment of the ***:Weight loss(P=0.016)and macroscopic examination scores(P=0.001)were significantly higher in saline group than *** scoring was comparable between all colitis groups(P=0.350).There was no significant difference in TNF-αlevels and IL-6 levels(P=0.150).CONCLUSION:The significant improvement in macroscopic scores suggests that levobupivacaine may have topical anti-inflammatory effects in an experimental colitis model;however,this finding was not supported by microscopic findings.

关键词： Trinitrobenzene sulfonic acid Colitis Levobupivacaine Budesonide

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Splenic hemangiopericytoma and serosal cavernous hemangiomatosis of the adjacent colon

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World Journal of Gastroenterology 2005年第26期11卷 4111-4113页

作者： tuncay yilmazlar Turkay Kirdak Omer Yerci Saduman B.Adim Ozkan Kanat Osman Manavoglu Department of General Surgery Uludag University School of Medicine Gorukle Bursa 16059 Turkey Department of Pathology Uludag University School of Medicine Gorukle Bursa 16059 Turkey Department of Medical Oncology Uludag University School of Medicine Gorukle Bursa 16059 Turkey

A healthy 31-years-old man presented with a three-year history of abdominal discomfort. Radiological examinations revealed multifocal tumoral lesions in the spleen. The patient underwent splenectomy for differential diagnosis and treatment. During the operation, in addition to the splenic masses, there were also multiple milimetric purpuric-like lesions on the colonic serosal surfaces adjacent to the splenic hilus. One of them was excised. Histologic examination showed hemangiopericytoma of the spleen and cavernous hemangioma of the adjacent colon. This is the first report showing the close association of these two distinct lesions with vascular origin in the literature. Despite not having any apparent evidence, there may be a sequential relationship between the hemangiopericytoma of the spleen and cavernous hemangiomas.

关键词： Hemangiopericytoma of the spleen Cavernous hemangiomatosis

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