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H Besim

Publications and source records attributed to H Besim.

7 recordsLinked to original sources

Xanthogranulomatous cholecystitis. Retrospective analysis of 12 cases.

Xanthogranulomatous cholecystitis is a rare variant of chronic cholecystitis characterized by severe proliferative fibrosis and accumulation of lipid-laden macrophages in areas of destructive inflammation. The macroscopic appearance generally mimics a gallbladder carcinoma. Twelve cases of xanthogranulomatous cholecystitis were identified from a retrospective analysis of the patient records of 770 cholecystectomy cases operated on in our department from January 1996 to October 2001. There were four men and eight women. Mean age of presentation was 52.5 years. Eleven patients had gallbladder stones. Seven patients had a history of acute cholecystitis and five patients of biliary colicky pain. Five cases were presented with obstructive jaundice and five with acute cholecystitis. Right upper quadrant mass was palpable in three patients. All patients underwent cholecystectomy. Open surgery was planned and performed in three patients. Laparoscopic cholecystectomy was planned in nine patients but converted to open surgery in three cases. Nine patients had an uneventful postoperative course. One patient developed wound infection and one patient a postoperative pulmonary infection. One patient developed acute abdomen in the 2nd postoperative day and was re-operated for bile peritonitis. No mortality was seen in the series.

Adult↗

Review of eight cases of insulinoma.

OBJECTIVE: To review patients records operated with the diagnosis of insulinoma and to discuss their clinical presentations, diagnostic and therapeutic modalities. DESIGN: Retrospective study. SETTING: Ankara Numune Teaching and Research Hospital, Turkey. SUBJECTS: Eight cases were operated in the Department of 6th Surgery, Ankara Numune Teaching and Research Hospital between 1994 and 2000. All patients had neuroglycopenic symptoms. Six patients had blood glucose levels of lower than 50 mg/dL during the admission. The other two patients had hypoglycaemia in the prolonged fasting test. Serum insulin/glucose ratio was diagnostic in all patients except one. Abdominal ultrasonography and computerised tomography could successfully localise the tumour in one case. In six patients tumours could be localised by endoscopic pancreatic ultrasonography. In one patient none of the studies could localise the tumour. Three tumours were located at the pancreatic head, one in the neck, two at the body and two at the tail. All tumours except one were palpable. Enucleation was the procedure of choice in four cases and distal pancreatectomy was the procedure of choice in four. RESULTS: Post-operative course was uneventful in seven patients. One patient died due to intra-abdominal sepsis. Hypoglycaemia was controlled in all patients after the surgery. CONCLUSION: Surgery is the mainstay of treatment of insulinoma. Enucleation should be the procedure of choice if possible. Endoscopic pancreatic ultrasonography has promising results and may replace invasive angiographic studies in the future.

Adult↗

Giant goitre.

Explore the source record for details and available documents.

Adult↗

Effect of hypertonic saline and alcohol on viability of daughter cysts in hepatic hydatid disease.

OBJECTIVE: To test the efficacy of hypertonic saline (20%) and absolute alcohol on the integrity of daughter cysts and the viability of the protoscoleces contained in these cysts. DESIGN: Experimental study. SETTING: Teaching hospital, Turkey. MATERIAL: 80 daughter cysts obtained from two patients with Gharbi type III hydatid cysts of the liver. INTERVENTIONS: The cysts were divided into two groups, in the first of which cysts were placed into hypertonic saline and in the second into absolute alcohol; they were kept there for 5, 15, 30 or 60 minutes. MAIN OUTCOME MEASURES: Integrity of the cyst wall and viability of the contents were evaluated using a vital staining technique with 0.1% eosin. RESULTS: Neither hypertonic saline nor absolute alcohol solution had any effect on the integrity of the daughter cysts or the viability of the protoscoleces. CONCLUSION: Percutaneous drainage of type III hydatid cysts can lead to high recurrence rates.

Cell Survival↗

Scolicidal agents in hydatid cyst surgery.

Injecting scolicidal solutions into the hydatid cyst and packing the operative field with sponges soaked in scolicidal agents have been used to avoid dissemination of the parasite during surgery. In the first part of this invitro study, we tried to determine the scolicidal property of various agents in different concentrations and exposure times. In the second part, we tested whether sponges soaked in different type and concentrations of scolicidal agents have any role beyond being a mechanical barrier. 20% saline, 3% hydrogen peroxide, 1.5% cetrimide-0.15% chlorhexidine (10% Savlon), 95% ethyl alcohol, 10% polyvinylpirrolidone-iodine (Betadine) and their further dilutions were used in this study. Protoscoleces were obtained from the cyst containing livers of the sheep and viability was determined with dye-uptake (0.1% Eosin) and flame cell activity. Savlon was found to be the least concentration dependent scolicidal agent among those studied. Scoleces sprayed on sponges soaked in 20% saline, 95% ethyl alcohol, Betadine and 3% hydrogen peroxide were killed after 15 minutes. 3% and 10% saline and normal saline were ineffective. Sponges work not only as a mechanical barrier but also as a chemical one if the agent is chosen correctly. In purely cystic hydatid liver disease, the risk of dissemination of the cyst contents can be avoided by injection of a potent scolicidal agent such as Savlon.

Animals↗

Thyroidectomy with and without drains.

Drainage after thyroid surgery has been widely used to prevent life-threatening complications. However, it is well known that drains do not always prevent haematoma formation. In this retrospective study, we reviewed our experience with 1057 thyroidectomies with and without drains in order to assess this issue. Between 1983 and 1993, 520 patients were closed with drains and 537 patients without drains after thyroid surgery. The indications for drainage of the selective period included wet operative field and large areas of dead space at the conclusion of the operation. Reoperation for bleeding was done in twelve patients in the drainage group and two patients in the non-drainage group (p < 0.05). Wound infection was seen in seven patients in the drainage group and none in the no-drainage group (p < 0.05). This study suggests that routine drainage after thyroid surgery is not necessary and a selective policy can be applied safely.

Adolescent↗