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1.
Eur Rev Med Pharmacol Sci ; 25(10): 3679-3683, 2021 05.
Article in English | MEDLINE | ID: mdl-34109577

ABSTRACT

OBJECTIVE: During pancreatic surgery for malignancies, hepatic revascularization is needed in case of en bloc resection with hepatic artery involvement. In these cases, the use of the splenic artery is described in the literature, including transposition and interposition techniques. PATIENTS AND METHODS: We report the case of pancreatic cancer resection with involvement of the right hepatic artery, anomalous arising from the superior mesenteric artery, and hepatic revascularization with splenic artery reconstruction. A literature review to analyze the use of splenic artery in hepatic revascularization during pancreatic cancer surgery was performed. RESULTS: A 61-year-old man with a 55-mm hypovascular tumor in the pancreatic head, in wide contact with the right hepatic artery, underwent total pancreatectomy and splenectomy. Right hepatic artery was resected, and the distal part of the splenic artery was transposed to the right hepatic artery with a termino-terminal anastomosis. Histopathological examination revealed R0 resection. CONCLUSIONS: Hepatic revascularization with splenic artery should be considered in patients suitable to extend resectability in pancreatic cancer surgery. A multidisciplinary approach and careful pre-operative planning are essential.


Subject(s)
Hepatic Artery/surgery , Liver/blood supply , Liver/surgery , Pancreatic Neoplasms/blood supply , Pancreatic Neoplasms/surgery , Splenic Artery/surgery , Humans , Male , Middle Aged , Plastic Surgery Procedures , Vascular Surgical Procedures
2.
G Chir ; 39(4): 239-244, 2018.
Article in English | MEDLINE | ID: mdl-30039792

ABSTRACT

INTRODUCTION: Although the intervention of knee arthroplasty became routine, there is no standard reference on the densitometric characteristics of the patella before and after surgery. Scope of this work is the evaluation of patellar bone density before and after unilateral knee arthroplasty. PATIENTS AND METHODS: BMD was assessed by DEXA examination in 146 individuals, who have been divided into three distinct groups. Group I: 68 subjects with a mean age of 70.6 years, with an unilateral femoral-tibial knee prothesis. Group II: healthy subjects of similar age (average: 64) and without implants. Group III: healthy adults with a mean age of 26.6 years. The follow-up was performed at 6 months to a maximum of 2 years post surgery. RESULTS: The results were obtained from 68 subjects examined with the DEXA software dedicated to the forearm, which turned out to be the most appropriate for our purpose. The follow-up performed every 6 months after surgery showed a reduction of the density values in the operated knee in the 1st control with a return to the pre-surgiucal situation in the control performed after 1 year. In subsequent checks there was a further increase of the patellar density of the operated knee. CONCLUSION: Patellar DEXA examination is recommended as an addition to the clinical and radiological standard examination.


Subject(s)
Arthroplasty, Replacement, Knee , Patella/chemistry , Absorptiometry, Photon , Adult , Age Factors , Aged , Aged, 80 and over , Bone Density , Bone Remodeling/physiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Movement , Osteoporosis/complications , Postoperative Period , Preoperative Period , Recovery of Function , Young Adult
3.
G Chir ; 38(2): 90-93, 2017.
Article in English | MEDLINE | ID: mdl-28691674

ABSTRACT

This study is aimed at identifying the collateral circulation in case of femoral-aorta-iliac axis obstruction, with the purpose of a more correct therapeutic indication being either medical or surgical or physiotherapeutic or combined.


Subject(s)
Intermittent Claudication/rehabilitation , Arterial Occlusive Diseases/complications , Collateral Circulation , Humans , Intermittent Claudication/etiology
4.
G Chir ; 37(4): 155-157, 2016.
Article in English | MEDLINE | ID: mdl-27938531

ABSTRACT

Pancreas divisum is a genetic defect associated with recurrent acute pancreatitis due to insufficient drainage of the accessory pancreatic duct. Seven young patients diagnosed with pancreatic divisum and thickening of the gallbladder bile as shown on magnetic resonance cholangio-pancreatography without pancreatic ductal changes underwent laparoscopic cholecystectomy. During the mean follow-up of 32 months no episode of pancreatitis was reported. There is an association between PD and higher concentration of bile in the gallbladder. Cholecystectomy can be considered curative in patients with PD in the absence of indications for major surgery.


Subject(s)
Cholangiopancreatography, Magnetic Resonance , Cholecystectomy , Gallstones/etiology , Gallstones/surgery , Pancreas/abnormalities , Pancreatitis/etiology , Adult , Cholangiopancreatography, Magnetic Resonance/methods , Female , Follow-Up Studies , Gallstones/diagnosis , Humans , Male , Prospective Studies , Recurrence , Treatment Outcome
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