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    The effect of caffeic acid phenethyl ester CAPE against cholestatic liver injury in rats
    (J Surg Res, 2010) Çoban, Sacid Abdussemet; Yıldız, Fahrettin; Terzi, Alparslan; Al, Behçet; Özgör, Dinçer; Ara, Cengiz; Polat, Alaadin; Eşrefoğlu, Mukaddes
    Objectives. Caffeic acid phenethyl ester (CAPE) has been subjected to considerable investigations that have revealed its antioxidant and anti-inflammatory activities in different conditions. But there is not a previous investigation about its effect on cholestatic liver injury. The aim of this study was to investigate the effect of CAPE in rat liver against cholestatic liver injury induced by bile duct ligation. Methods. Swiss-albino rats were recruited in the study as follows; Group 1 rats subjected to simple laparotomy known as the sham group; Group 2 rats subjected to bile duct ligation (BDL); Group 3 bile duct ligated rats treated with CAPE. The third group received CAPE (10 mmol/kg) intraperitoneally daily throughout 14 d. Results. Data showed a decrease in g glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase levels (ALT) of the CAPE treated rats, compared with BDL group (P < 0.001, P < 0.01, and P < 0.02, respectively). In the CAPE treated rats, tissue levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were significantly lower than that of the BDL group (P < 0.001). The levels of glutathione (GSH) in CAPE treated rats were significantly higher than that of BDL group (P < 0.001). In CAPE treated group, the levels of interleukin- 1alpha (IL-1a) and interleukin-6 (IL-6) were signifi- cantly lower than that of BDL group (P < 0.03, P < 0.02, respectively). Administration of CAPE in the rats with biliary obstruction resulted in inhibition of necro-inflammation.Conclusion. These results suggest that treatment of CAPE maintains antioxidant defenses, reduces oxidative liver injury, cytokine damage, and necroinflammation in bile duct ligated rats. Thus, CAPE seems to be a promising agent for the attenuation of cholestatic liver injury.
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    Partial hepatectomy is curative for the localized type of Caroli sdisease A case report and review of the literature
    (Surgeon-Journal of the royal colleges of surgeons of edinburgh andireland, 2006) Yılmaz, Sezai; Kırımlıoğlu, Saime Hale; Kırımlıoğlu, Vedat; Işık, Burak; Çoban, Sacid Abdussemet; Ara, Cengiz; Söğütlü, Gökhan; Yılmaz, Mehmet
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    Resection and primary anastomosis with or without modified blow hole colostomy for sigmoid volvulus
    (World J Gastroenterol, 2008) Çoban, Sacid Abdussemet; Yılmaz, Mehmet; Terzi, Alparslan; Yıldız, Fahrettin; Dinçer, Özgör; Ara, Cengiz; Yoloğlu, Saim; Kırımlıoğlu, Vedat
    To evaluate the efficacy of resection and primary anastomosis (RPA) and RPA with modified blow-hole colostomy for sigmoid volvulus. METHODS: From March 2000 to September 2007, 77 patients with acute sigmoid volvulus were treated. A total of 47 patients underwent RPA or RPA with modified blow-hole colostomy. Twenty-five patients received RPA (Group A), and the remaining 22 patients had RPA with modified blow-hole colostomy (Group B). The clinical course and postoperative complications of the two groups were compared. RESULTS: The mean hospital stay, wound infection and mortality did not differ significantly between the groups. Superficial wound infection rate was higher in group A (32% vs 9.1%). Anastomotic leakage was observed only in group A, with a rate of 6.3%. The difference was numerically impressive but was statistically not significant. CONCLUSION: RPA with modified blow-hole colostomy provides satisfactory results. It is easy to perform and may become a method of choice in patients with sigmoid volvulus. Further studies are required to further establish its role in the treatment of sigmoid volvulus.
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    Transabdominal approach in the surgical management of morgagni hernia
    (Surgery Today, 2006) Yılmaz, Mehmet; Işık, Burak; Çoban, Sacid Abdussemet; Söğütlü, Gökhan; Ara, Cengiz; Kırımlıoğlu, Vedat; Yılmaz, Sezai; Kayaalp, Cüneyt
    Purpose. Morgagni hernias are uncommon diaphragmatic hernias that are generally asymptomatic, and so far only limited data have been reported. The objective of this retrospective study was to evaluate the outcome of patients presenting with a complicated Morgagni hernia and who undergo a transabdominal repair. Methods. Between September 1999 and October 2005, 11 patients with Morgagni hernia were operated on in our department. Eight of them had acute presentations because of a complicated Morgagni hernia. The patient demographics, presenting symptoms, operative approach, and complications were collected. The postoperative course was evaluated for morbidity and mortality. Results. The patients’ ages ranged from 42 to 85 years (mean 69.4). Two (18.2%) patients were male and nine (81.8%) patients were female. Chest roentgenograms, computed tomography, and contrast meal studies were used as diagnostic utilities. A transabdominal approach was used for all patients. One patient died due to pulmonary failure. The mean follow-up was 2.8 years. There was no recurrence or symptoms regarding the operation in the remaining patients. Conclusion. We recommend the transabdominal approach in patients with Morgagni hernia as it makes it easy to reduce the hernia contents and repair of the hernia sac. Moreover, when complicated with strangulation, incarceration or perforation, a surgical repair through a transabdominal approach is mandatory.