Influence of Biliopancreatic Diversion on Pregnancy Outcomes in Comparison to Other Bariatric Surgery Procedures.

BACKGROUND: Pregnancy after bariatric surgery (BS) has an increased risk for small-for-gestational-age infants (SGA), shorter length of gestation, and probably perinatal mortality. The aim of this study was to investigate if biliopancreatic diversion could impair pregnancy outcomes in comparison to other bariatric surgery procedures. METHODS: We conducted a cohort retrospective single-center study in 65 women before and after BS. Thirty-one pregnancies occurred before BS, while 109 after BS, amongst which n = 51 after biliopancreatic diversion (BPD) and n = 58 after non-malabsorptive procedures. RESULTS: The pregnancy outcomes after BS in comparison with those before BS resulted less affected by diabetes, hypertensive disorders, macrosomia, and large-for-gestational-age (LGA), but more complicated by preterm births (14.5 versus 4.0%) and low birth weight (LBW) infants (28.9 versus 0%). Moreover, mean birth weight resulted lower after BS than before BS (p < 0.001). In pregnancies after BPD in comparison to those before BS, the LBW rate (42.5%) resulted a drastic increase (p < 0.001), and mean birth weight (p < 0.001) and mean birth weight centile (p < 0.001) were lower after BPD. When pregnancy outcomes after BPD were compared with those after non-malabsorptive procedures, the rate of congenital anomalies, preterm births, LBW, and SGA resulted an increase (p = 0.002, 0.008, 0.032, and < 0.001, respectively). CONCLUSIONS: BPD drastically reduced diabetes, hypertensive disorders, macrosomia, and LGA; however, it was associated with the poorest pregnancy outcomes in comparison to those observed after other BS procedures. On the basis of the present study, we recommend a cautious multidisciplinary selection of severely obese patients for BPD during the fertile age.

[Thermal ablation by radiofrequency of hepatic metastasis of colorectal cancer: short-term results]. / Termoablazione mediante radiofrequenza di metastasi epatiche da cancro colorettale: risultati a breve termine.

Radiofrequency (RF) was used to ablate 42 colorectal liver metastases in 20 patients (10 males and 10 females) in a four years period. Median age was 62.2 years, 36 lesions (75%) had 3 cm diameter or less. An open surgical approach was adopted in 13 patients, whereas a percutaneous one in 14. On 27 surgical sessions, RFA was used in 49 procedures for a total of 81 needle applications. Morbidity was 6.0% (3 cases), one patient died on third po day for myocardial infarction. No differences in terms of complete ablation rate was observed in the two approach's groups. Overall survival was 65% with a median follow-up of 18.5 months.

[Gastrointestinal stromal tumors: relationship between clinical factors and immediate results after resective surgery]. / Tumori stromali gastrointestinali: relazione tra fattori clinici e risultati immediati dopo chirurgia resettiva.

The impact of different clinical features on surgical strategy and immediate results after resection is investigated in a consecutive series of 47 gastrointestinal stromal tumors.

[Effect of preoperative biliary drainage on the immediate and long-term results after duodeno-cephalo-pancreatectomy for peri-ampullar neoplasia]. / Effetti del drenaggio biliare preoperatorio sui risultati immediati e a distanza dopo duodenocefalopancreasectomia per neoplasia periampollare.

Pancreaticoduodenectomy has a primary role in the treatment of patients with periampullary carcinoma. Several series have reported encouraging operative mortality and survival after resection. Controversies exist regarding the impact of preoperative biliary drainage on immediate and long-term results.

Diagnostic laparoscopy in a HIV positive patient with disseminated non-Hodgkin's lymphoma.

We report a case of massive peritoneal involvement in AIDS-related non-Hodgkin's lymphoma (NHL). Abdominal CT scan showed a retroperitoneal lymphoadenopaty and a wide thickening of omental peritoneum. At laparoscopy a diffuse massive involvement of peritoneum mimicking carcinomatosis was demonstrated and an omentum biopsy revealed a diffuse infiltration of large cell NHL.