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M Akoglu

Publications and source records attributed to M Akoglu.

13 recordsLinked to original sources
PubMed2004

Effect of carbon dioxide pneumoperitoneum on the severity of acute pancreatitis: an experimental study in rats.

BACKGROUND: In the management of mild acute biliary pancreatitis, it is generally recommended to perform laparoscopic cholecystectomy after the subsidence of the attack during the same hospital admission. The effect of laparoscopy on abdominal organs has been widely investigated but not in acute pancreatitis. This study used an animal model of mild acute pancreatitis to examine the effects of CO(2) pneumoperitoneum on acute pancreatitis in rats. METHODS: Mild acute pancreatitis was induced in 30 male Sprague-Dawley rats by surgical ligation of the biliopancreatic duct. After 2 days, animals were assigned to three groups: sham operation (animals were anesthetized for 30 min without undergoing laparotomy), CO(2) pneumoperitoneum (applied for 30 min at a pressure of 12 mmHg), and laparotomy (performed for 30 min, and then the abdomen was closed). Two hours after the surgical procedures, animals were killed and levels of lactate dehydrogenase, aspartate aminotransferase, glucose, urea, hematocrit, and leukocyte count among Ranson's criteria and levels of amylase, lipase, and total bilirubin were measured to determine the severity of acute pancreatitis. Histopathologic examination of the pancreas was done, and malondialdehyde and glutathione levels of the pancreas and lung were determined. RESULTS: The only significant differences between the groups were in lactate dehydrogenase and aspartate aminotransferase levels, which were significantly higher in the pneumoperitoneum group compared to the sham operation group. CONCLUSION: CO(2) pneumoperitoneum for 30 min at a pressure of 12 mmHg did not affect the severity of acute pancreatitis induced by ligation of the biliopancreatic duct in rats.

Acute Disease↗
PubMed2004

Comparison of complications after D2 and D3 dissection for gastric cancer.

BACKGROUND: D3 dissection is accepted as having higher rates of mortality and morbidity than D2 dissection. In this study, we aimed to evaluate the mortality and morbidity rates of D3 dissection in our department and to compare these with mortality and morbidity after D2 dissection. PATIENTS AND METHODS: All patients who underwent radical gastric resection with lymph node dissection for gastric adenocarcinoma between June 1999 and June 2002 were evaluated. Clinicopathologic features of the tumour, the resection and lymphadenectomy, the postoperative mortality and morbidity were analysed. RESULTS: There were 359 patients admitted for the treatment of gastric cancer. One hundred twenty four underwent palliative resection and 134 underwent resection with curative intent. Of 34/134 patients, underwent gastric resection with D3 dissection, and 100 underwent D2 dissection. The overall operative mortality rate of D2 and D3 dissections was 1 and 8.8%, respectively (p<0.05). The relaparotomy rate was almost doubled in D3 dissection group (11.8% vs. 6%) but this difference was not statistically significant. D3 dissection was also associated with an increase in morbidity (35.3% vs. 10%, p<0.05). CONCLUSIONS: This study indicates that D3 dissection can be performed with reasonable safety. It may be a useful alternative procedure in advanced cases for which additional risks of surgical morbidity and mortality are felt to be outweighed by potential benefits to patients.

Adenocarcinoma↗
PubMed2003

Evaluation of the outcomes of short bowel syndrome and indications for intestinal transplantation.

Long-term parenteral nutrition (PN) and intestinal transplantation (IT) are life-saving therapies for patients with short bowel syndrome (SBS). However, indications and timing of these therapies are controversial. In this study we aimed to evaluate the indications for IT. Forty-two patients, each with <100 cm of small bowel, were divided into three groups according to the length of remnant: group I patients (n = 18): colon plus 50 to 100 cm of small bowel (SB); group II patients (n = 14): colon plus <50 cm of SB; and group III patients (n = 10): <50 cm of SB without colon. One-year mortality rates for groups I, II, and III were 50%, 72%, and 100%, respectively. All group I survivors developed intestinal adaptation, returning to regular oral feedings at 1 year. Interestingly, three of four surviving patients in group II developed adaptation and were fed an oral short bowel diet (SBD) at 1 year. None of the group III patients survived >1 year, dying due to multiorgan failure in the early postoperative period or from sepsis within 1 year. We conclude that patients with a very short bowel are candidates for IT when stable. If the colon is intact, however, regardless of small bowel remnant length, the patient should be given a chance to develop intestinal adaptation before making the decision for permanent PN or IT.

Adolescent↗
PubMed2001

Hypertonic saline in hydatid disease.

The objective of this study was to determine the scolicidal effects of saline in different concentrations using different exposure times and to examine whether hypertonic saline can be used to irrigate the abdomen when there is a free intraperitoneal perforation of hydatid disease. Various concentrations of saline solutions (0.09%, 3.0%, 6.5%, 10%, 15%, 20%, 25%, 30%) were added to concentrated echinococcus granulosus sediments for the following times: 1, 2, 3, 4, 5, 10, 15, 30, 45, and 60 minutes. Normal (0.09%), 3.0%, and 6.5% saline resulted in high viability ratios after 60 minutes' exposure. Complete lethality for 10%, 15%, 20%, 25%, and 30% saline occurred at the end of 75, 10, 6, 3, and 3 minutes, respectively. During the second part of the study, 20 Sprague-Dawley rats were used for abdominal saline irrigation in four groups: 30% NaCl for 3 minutes; 20% NaCl for 6 minutes; intravenous isotonic dextrose water and furosemide plus 30% NaCl irrigation for 3 minutes; the same prophylactic therapy plus 20% NaCl irrigation for 6 minutes. Sodium and chloride values rose significantly (20-30%) shortly after hypertonic saline irrigation in each group (p < 0.01). Support with isotonic dextrose and furosemide before irrigation did not have any beneficial effect on biochemical values or mortality. The 24- and 48-hour mortality rates were 70% and 90%, respectively. These studies illustrate that the scolicidal effect of hypertonic saline is limited in low concentrations, but an increase in the concentration can augment its adverse effects. Peritoneal irrigation with hypertonic saline should be avoided for intraabdominal perforated hydatid disease. Therefore, we concluded that hypertonic saline is not a good scolicidal agent to prevent recurrence of hydatid disease.

Animals↗
PubMed2001

Effectiveness of endoscopic treatment modalities in complicated hepatic hydatid disease after surgical intervention.

BACKGROUND AND STUDY AIMS: Hepatic hydatid cyst is a common disease in Turkey and the rupture of the cyst into the biliary tract is the most common complication which is difficult to detect and to manage. The aim of this study was to investigate the effectiveness of endoscopic treatment modalities in hydatid cyst patients with biliary complications who had previously undergone surgery. PATIENTS AND METHODS: Over the last 8 years, by means of endoscopic retrograde cholangiopancreatography (ERCP), we have examined 87 patients with postoperative biliary symptoms who had previously undergone surgery for hepatic hydatid disease of the liver. Endoscopic treatment modalities were as follows: endoscopic sphincterotomy (ES) and nasobiliary drainage in patients with biliary fistula; balloon and or bougie dilation and stenting in patients with biliary stricture; and ES and balloon extraction in patients with residual hydatid material within the bile duct. RESULTS: Findings from ERCP included biliary fistula in 55 patients (63.2 %), biliary stricture in 16 (18.4 %), and residual hydatid material within the bile duct in 14 (16.1 %). Two patients had normal findings on ERCP. In total, 85 patients were treated by means of endoscopic modalities. The time to closure of fistula was 17.8 +/- 5 days and the rate of fistula closure was 81 %. Biliary stenting was performed in 13 patients with biliary stricture. Endoscopic removal of hydatid material was achieved in 14 patients. The overall success rate of endoscopic treatment was 86 %, and a second surgical intervention was required only in six patients. No serious complication was encountered after endoscopic procedures. CONCLUSIONS: Endoscopic treatment modalities are safe and helpful methods for the treatment of biliary complications of hepatic hydatid cyst in the postoperative period.

Adolescent↗
PubMed1992

A rational approach to the terminology of hydatid disease of the liver.

Hydatid disease is one of the most important global health problems. Areas of progress in its management, however, remain unclear due to the incomplete, confusing and conflicting terms which have been used to describe it. To avoid this confusion it is proposed that the management of hydatid disease of the liver should be classified as follows. The hydatid cyst may be described as univesicular, multivesicular or secondary abdominal implantation. The surgical treatment of the cyst may be adequately described as either evacuation, enucleation, pericystectomy or hepatectomy and the method of treating the residual cavity in the liver following surgery as leaving open, suture-closure, closed tube drainage or marsupialisation. This classification is felt to be comprehensive and its application may avoid the confusion which is currently present in the literature on hydatid disease of the liver.

Echinococcosis, Hepatic↗
PubMed1992

Extended transduodenal sphincteroplasty for bile duct stones associated with a periampullary diverticulum.

Extended transduodenal sphincteroplasty has been suggested as an alternative to choledochoduodenostomy for the surgical management of bile duct stones associated with a periampullary diverticulum but its value has not previously been investigated. Over a 3 year period, nine patients underwent extended transduodenal sphincteroplasty for common bile duct calculi associated with a periampullary diverticulum with no operative or post-operative mortality and minimal morbidity. Follow-up ranging from 20 to 60 months has shown remission of pain in all but one patient, who has had a normal endoscopic cholangiogram and no further episodes of jaundice or cholangitis. Extended transduodenal sphincteroplasty is a safe and effective alternative to choledochoduodenostomy for the surgical management of choledocholithiasis associated with a periampullary diverticulum.

Aged↗
PubMed1991

Caroli's disease misdiagnosed as hydatid liver cysts.

A 27 year old woman who presented with upper abdominal pain was found on ultrasonography to have multiple liver cysts consistent with hydatid disease. Three years previously she had undergone evacuation of multiple infected liver cysts thought to be due to hydatid disease. Computed tomographic scanning supported the diagnosis of hydatid disease affecting the right lobe of the liver. At laparotomy the right lobe contained multiple cysts which were removed by right lobectomy. Histology revealed congenital dilatation of the intrahepatic bile ducts with fibrosis (Caroli's disease) but no evidence of hydatid disease.

Adult↗
PubMedDate not supplied

Right liver necrosis: complication of laparoscopic cholecystectomy.

Although bile duct injuries are common among the complications of laparoscopic cholecystectomy, hepatic vascular injuries are not well described. Between January 1990 to December 1999, 83 patients with bile duct injuries have been referred to our clinic. Two of them had liver necrosis due to hepatic arterial occlusion. These two women had laparoscopic cholecystectomy for symptomatic cholelithiasis in district hospitals 4 and 15 days prior to their referral to our clinic. Serum aspartate aminotransferase and alanine aminotransferase levels were found to be 30 to 40-fold higher than normal levels. Ultrasonography, computed tomography and Doppler sonography showed necrosis in the right liver lobe and no flow in the right hepatic artery. Patients were also complicated with liver abscess and biliary peritonitis, respectively. Emergency right hepatectomy was performed in both cases and one of them needed Roux-Y-hepaticojejunostomy (to the left hepatic duct). One patient died of peritonitis in the postoperative period. The other one has no problem in her third postoperative year. The earliest and the simplest method for diagnosis or ruling out hepatic arterial occlusion is detecting the blood biochemistry and Doppler ultrasonography. In some cases emergency hepatectomy can be necessary. Postoperative complications should be expected higher than elective cases.

Abdominal Pain↗
PubMedDate not supplied

Management of postoperative biliary strictures secondary to hepatic hydatid disease by endoscopic stenting.

BACKGROUND/AIMS: The cases in the present study were reviewed retrospectively with the aim to demonstrate the characteristics of these strictures as well as the effectiveness of endoscopic stenting and to discuss the possible mechanisms of stricture formation. METHODOLOGY: Thirteen cases of postoperative benign biliary strictures secondary to hepatic hydatid disease (HHD) surgery were diagnosed between 1989 and 1994. All of these cases had had surgery for HHD one or more times. Endoscopic stenting was performed in 11 of the cases. Eight cases were followed-up. RESULTS: In 3 (29%) of the 8 cases, the stents were removed after a mean period of 35.6 months, and the patients were considered cured. These cases have been followed-up for 28 months. The remaining 5 cases have been followed-up for a mean period of 14.2 months. The overall morbidity was 18%, and there were no mortalities. The postoperative benign biliary strictures secondary to HHD were long, multiple, and located proximally. Due to these properties, surgical repair was not indicated for these cases. CONCLUSION: Endoscopic stenting is a safe method in the treatment of postoperative benign biliary strictures secondary to hepatic hydatid disease.

Adult↗