Biomedical subjects

Roberto Sivelli

Publications and source records attributed to Roberto Sivelli.

7 recordsLinked to original sources

PubMed2006

Videolaparoscopic cholecystectomy for acute cholecystitis: analyzing conversion risk factors.

We examined a series of 176 consecutive patients scheduled for videolaparoscopic cholecystectomy for acute cholecystitis to identify the independent parameters most likely to lead to conversion to laparotomy. This prospective study was conducted from June 2001 to December 2003 on 176 consecutive patients who were scheduled for videolaparoscopic cholecystectomy for acute cholecystitis. Of the 176 patients, 119 (group A) underwent videolaparoscopic chlecystectomy, and 57 (32.3%) were converted to laparotomy (group B). Patients were assessed for gender, age, time between onset of symptoms and surgery, previous surgery, ASA (American Society of Anesthesia) risk, leukocytosis, echotomographic findings, average operating time, intra- and post-operative complications, and conversion rate. Our study found that the parameters of age, ASA risk, duration of symptoms, leukocytosis, and operative time are independent conversion risk factors.

Aged↗

PubMed2002

Gastrointestinal stromal tumours: an analysis based on personal experience.

We present our experience in the treatment of 18 patients affected by gastrointestinal stromal tumours (GIST) from January 1988 to march 2002. The ratio M.F was of 2:1 and the median age of 68.6 years. In 13 patients the tumours were located in the stomach while in 5 patients in the jejunum ileum area. In 7 patients the neoplasms were malignant. All the patients were operated and in 11 patients a partial gastric resection was carried out. 2 patients had a total gastrectomy and 5 had a small bowel resection. The diagnostic and therapeutic options and the uncertain prognosis of these neoplasms are discussed.

Aged↗

PubMedDate not supplied

[Gastric polyps: a clinical contribution].

The incidence of diagnosis of gastric polyps is now higher than in past years owing to the introduction of endoscopy in the diagnosis and treatment of upper digestive tract disease. One hundred and sixty-four polyps removed from January 1984 to August 2000 were analyzed. The median age of the patients was 61.4 years (range: 16-84 yrs). Polypoid lesions were more frequent in males (M:F = 1.5:1). Seventy-nine patients were asymptomatic (48.2%). Sixty-four percent of the polyps were located in the antrum. We diagnosed 73 hyperplastic polyps, 27 adenomatous lesions, 8 inflammatory polyps and 56 pseudopolyps. Malignant lesions were detected in 9 adenomatous polyps (4 type I and 5 type II early gastric cancers). Endoscopy is the examination of choice in the diagnosis and treatment of gastric polyps. We confirm that there is a relationship between histological type, neoplastic change and the size of the polyps.

Adolescent↗

PubMedDate not supplied

Bouveret's syndrome: a case report.

Duodenal obstruction due to a gallstone from a cholecystoduodenal fistula (Bouveret's syndrome) is a rare complication of gallstone disease. Patients present gastric outlet occlusion with vomiting, abdominal distension and a state of dehydration. Plain film of the abdomen, ultrasonography and CT scans reveal pneumobilia and the obstructing gallstone. Endoscopy is essential for diagnosis and therapy, with a view to the possibility to relieving the occlusion. Endoscopy, however, cannot be used to treat the fistula and is often unsuccessful because of the very large size of the stone. Surgical therapy can be effective both for relieving the occlusion and for fistula treatment. The authors report a case of Bouveret's syndrome successfully treated surgically in an otherwise healthy patient. In critically ill patients, the primary goal of therapy is relief of the occlusion.

Aged↗

PubMedDate not supplied

Wireless capsule endoscopy in a case of small bowell obstruction: not always contraindicated.

Wireless capsule endoscopy is a new diagnostic technique used especially for investigating the entire small bowel. Recent studies have demonstrated its superior ability to detect and evaluate small bowel lesions compared to other radiological examinations. Performing video capsule endoscopy is regarded as contraindicated when an intestinal occlusion is documented. We present a case of hidden intestinal bleeding which underwent wireless capsule endoscopy and was treated successfully despite documented ileal stenosis.

Adenocarcinoma↗

PubMedDate not supplied

[Rupture of the spleen in angiosarcoma: a case report and review of the literature].

Splenic angiosarcoma is a rare neoplasm originating from endothelial cells of the blood vessels. Its incidence is about 0.14-0.25 per million. We report the case of a patient admitted in a state of hypovolaemic shock with haemoperitoneum due to rupture of the spleen. Splenectomy was performed with evacuation of the haemorrhagic effusion. The blood was aspirated and in part instilled during the operation through intraoperative blood salvage due to the large haemoperitoneum. Histological examination revealed a splenic angiosarcoma. Splenic angiosarcoma should be suspected in cases of splenomegaly with unknown anaemia and no lymphoma, leukaemia or myelofibrosis, because of its neoplastic aggressiveness and its invariably fatal outcome. It is important to perform a splenectomy before splenic rupture owing to its negative impact on long-term survival.

Aged↗

PubMedDate not supplied

[Considerations regarding the role of arterial embolization with an angiographic approach in the treatment of upper gastrointestinal bleeding: personal experience].

Upper gastrointestinal bleeding can be produced by varicose, inflammatory-ulcerative or neoplastic lesions of the eosophageal-gastric-duodenal anatomical district. The aim of this study was to define the role of arterial embolotherapy with an angiographic approach in the treatment of these conditions, starting from our personal experience and a review of the literature. The treatment of upper gastrointestinal bleeding is based on a multimodal approach in which arterial embolotherapy has its place alongside endoscopy and surgery.

Adult↗