ABSTRACT
Objectives: Pancreatic resection may be required in the treatment of patients with pathologies of the pancreas. Total pancreatectomy is a major surgical procedure with serious risk of mortality and morbidity, and patient selection is important for prognosis. The endocrine and exocrine pancreatic insufficiency that develops in patients after total pancreatectomy can lead to a serious decrease in the quality of life of the patients due to pain, diarrhea, vomiting etc. Our aim was to evaluate the effect of total pancreatectomy with spleen preservation as well as splenectomy on the quality of life of the patients. Material and Methods: In our study, we retrospectively analyzed the data of patients diagnosed with pancreatic cancer, intrapapillary mucinous neoplasia, pancreatic neuroendocrine tumors, and chronic pancreatitis undergoing from partial to total pancreatic resections in our clinic between 12/2017 and 12/2022. Quality of life was compared using the EORTC QLQ-C30 scale. Results: A total of 47 total pancreatectomy patients, 30 (63.8%) males and 17 (36.2%) females, were included in the study. Mean age of the patients was 61.38 (39-83) years. Five (35.7%) patients underwent perioperative total pancreatectomy because of high risk of pancreatic fistula development due to hard parenchyma and narrow pancreatic duct. Patients had a perioperative blood loss of 500 mL or more, and there was a statistically significant increase in perioperative blood loss compared to patients without vascular resection (p <0.001). Forty (85.1%) patients used enzyme preparations to replace pancreatic enzymes. Conclusion: After total pancreatectomy, quality of life of the patients is reduced both by surgical factors and by metabolic factors due to endocrine and exocrine insufficiency in the postoperative period.
ABSTRACT
Background and Aim: Alcohol-induced liver disease has become one of the major causes of chronic liver disease worldwide with the increasing use of alcohol in society. The most important step in treatment is cessation of alcohol consumption. In patients with advanced liver disease, the most effective treatment is liver transplantation. Careful evaluation of patients with alcoholic liver disease before transplantation can help identify those at high risk of relapsing. Materials and Methods: Of a total of 42 patients who underwent liver transplantation for alcohol-related liver failure in our hospital between 2011 and 2022, 26 surviving patients were included in the study. Patient data were analyzed retrospectively. Demographic data, MELD score, history of alcohol consumption, alcohol treatment, post-transplant prognosis and survival were analyzed. The Barratt Impulsivity Scale-11 Short Form (BIS-11 SF) was applied to the surviving patients for impulsivity analysis to predict the possibility of relapse. Results: Of the 26 patients who were included in the study, all were male. The mean age at transplantation was 53 (31-71) years. Mean MELD score was 22.31 (9-36). 12 patients (46.2%) received living donor liver transplantation and 14 patients (53.8%) received cadaveric liver transplantation. 25 patients (96.2%) had no post-transplant dependence, while 1 patient (3.8%) had post-transplant dependence. 5 patients (19.2%) continued to consume alcohol after transplantation. Conclusion: In our study, we observed that patients with high motor impulsivity tendency according to BSI-11 SF had alcohol relapse. We believe that revising this scale with more detailed questions for alcohol-dependent liver patients and applying it to patients before transplantation will be effective in better selection for transplantation and guiding patients to appropriate therapy and thus preventing relapse after transplantation.
ABSTRACT
Background As the coronavirus disease 2019 (COVID-19) pandemic started, some restrictions were imposed throughout the country. The pandemic caused disruption, reduction, and even a halt in health services worldwide. During this period, the number of procedures performed in surgical clinics decreased due to the interruption of services and the restriction in patient admissions. Methodology In this study, we aimed to evaluate the effect of the pandemic on the number of surgeries performed in our clinic during the pre- and post-pandemic period by evaluating the following elective surgeries conducted between September 2018 and September 2021: upper gastrointestinal system, abdominal wall hernia, gallbladder surgeries, and kidney transplantation. Results A significant decrease was observed in the number of operations before and after the pandemic in our clinic. Conclusions In our opinion, both the Ministry of Health and healthcare institutions should increase the necessary precautions, organize the planning and programming in hospitals, and increase efforts in protecting healthcare workers and patients by increasing surgical practices and ensuring that the healthcare services we provide reach the numbers noted during the pre-pandemic period.
