ABSTRACT
OBJECTIVE: Iatrogenic bile duct injuries remain a challenge for the surgeons to overcome. The predictive factors affecting morbidity and mortality are important for determining the best management modality. MATERIAL AND METHODS: The patients who referred to Ege University Faculty of Medicine after laparoscopy associated iatrogenic bile duct injury are grouped according to Strasberg-Bismuth classification system. The type and number of prior attempts, concomitant complications, and treatment modalities are analyzed using the SPSS version 18 (IBM, Chicago, IL, USA). The variables with p<0.10 were considered for univariate analysis and then evaluated for predictive factors by forward Logistic Regression method using multiple logistic regression analysis. RESULTS: According to the analysis of 105 patients who were referred during 2004-2014, the type and number of prior attempts are considered predictive factors in sepsis. In multiple logistic regression analysis, abscess formation, concomitant vascular injury, and serum bilirubin level are significantly effective in predicting mortality. CONCLUSION: The management of iatrogenic bile duct injuries should be carefully planned with a multidisciplinary approach. The predictive factors affecting morbidity and mortality are important in determining the best modality for managing iatrogenic bile duct injuries. Abscess formation, vascular injury, and serum bilirubin level are the potential risk factors. Therefore, we can strongly recommend immediate assessment of patients for prompt diagnosis and referring to an HPB center, to avoid further injuries.
ABSTRACT
OBJECTIVE: In recent years, major progress has been made in the field of endocrine surgery in Turkey, similar to that in the rest of the world. Parallel to these developments, there has been a significant increase in the number of publications in the related field. Our study aimed to evaluate Turkey's publications related to endocrine surgery in the international arena. MATERIAL AND METHODS: Members of the general surgery departments from academic centers in Turkey were determined. Using these member names, a PubMed search was performed for English papers related to "endocrine surgery." For searching papers from non-academic centers, the same engine was used. To reach manuscripts possibly missed by the PubMed search, 3 national calls were made through the website of the Turkish Society of Endocrine Surgery. The obtained papers were divided into "thyroid," "parathyroid," "adrenal," and "neuroendocrine tumors" and were listed according to the publication year. In addition, all manuscripts were listed according to the publishing journal and the 2012 impact factor of that journal. This study did not require ethical approval, because it did not involve evaluation of experimental or patient data. RESULTS: A search of Turkish general surgery clinics revealed 497 international publications, between 1976 and 2012. When listed according to the year of publication, most publications were found to be in the year 2009. Papers appeared mostly in "Surgery Today." The mean impact factor of the journals where the papers have been published was 1.9 (0.1-13.8). The rates of thyroid, parathyroid, adrenal tissue and neuroendocrine tumors related publications were 69%, 10%, 15% and 6%, respectively. Since this study is not an experimental study or a study related to patient data, we did not apply for ethical approval. CONCLUSION: The contribution of Turkish general surgeons' to world science is apparent when evaluated in terms of publications related to endocrine surgery until recently. Particularly, since 2002, with the increase in the number of publications in the field of endocrine surgery, there has been an increase in Turkey's importance on the international platform.
