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    Asymptomatic cholecysto-enteric fistula and gallstone ileus: Two case reports
    (2019) Yilmaz, Tugbahan; Arslan, Baha; Erol, Varlik; Gulay, Huseyin
    Cholecysto-enteric fistula (CEF) is an uncommon complication that can be seen incidentally during elective surgery or as a cause of mechanical intestinal obstruction. It usually involves elder females having comorbid conditions. Stones that pass into the small intestine due to CEF present themselves with recurrent ileus attacks and the clinical picture becomes apparent in case of complete obstruction. Very small stones, however, can be eliminated from the digestive system without causing ileus. There is no predictor for the development of CEF either in patients unaware of their gallstone or in those aware of their gallstone but asymptomatic. Thus, the diagnosis is established based on tests performed in emergency conditions or accidentally during elective surgery. Herein, we present two cases; the one with gallstone ileus due to CEF and the other with CEF detected during elective surgery
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    Benefits and reliability of laparoscopic sleeve gastrectomy in patients aged 60 years and older
    (2019) Erol, Varlik; Arslan, Baha; Tuncali, Bahattin; Ozvardar Pekcan, Yonca; Altin, Cihan; Han Yilmaz, Tugba; Gulay, Huseyin
    Aim: Obesity is a disease that reduces the quality and duration of life and its prevalence is also increasing in the elderly population.In this study, we aimed to investigate the results of early and midterm weight loss and treatment of concomitant diseases and evaluate the safety and efficacy of bariatric surgery in patients aged 60 years and older who underwent Laparoscopic Sleeve Gastrectomy (LSG) in our clinic. Material and Methods: We retrospectively evaluated 28 morbid obese patients ≥60 years oldwho underwent LSG between September 2014 and January 2018.Data reviewed included age, sex, preoperative weight and body mass index (BMI), comorbid conditions, early or delayed complications, mortality, length of follow-up, weight lost, BMI points lost, and effects on obesity-related comorbid conditions. Results: Of 28 patients included in the study there were 22 (78.6%) females and 6 (21.4%) males. The average age of patients was 63.4±3.39.Preoperative mean BMI was 48.4±7.0kg/m2 .Average follow-up period 20.67 month. Postoperative median BMI was,36.24kg/m2 in the 6th month, 33.47kg/m2 in the 1st year and 31.17kg/m2 in the 2nd year.Present comorbid conditions included 23 (82.1%) hypertension, 16 (57.1%) diabetes mellitus and 3 (10.7%) obstructive sleep apnea. All of patients reported resolution or improvement in comorbid conditions.No mortality was observed in patients. Conclusion: Outcomes and complication rates of bariatric surgery in patients aged 60 years and older are low and acceptable. The results of our study support bariatric surgery in elderly patients. However, detailed information should be provided about the slightly increased risks and the possibility of less satisfactory outcome.
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    The effect of amniotic membrane wrapping on colorectal anastomosis in rats undergoing pelvic radiotherapy
    (2020) Arslan, Baha; Aksoy, Suleyman Ozkan; Terzi, Mustafa Cem; Sevinc, Ali Ibrahim; Mehtat Unlu, Sadiye; Alanyali, Hilmi Feyzi; Simsek Keskin, Hatice
    Aim: This study aimed to investigate the effect of amniotic membrane wrapped onto the anastomosis line following colon resection and primary anastomosis on anastomosis healing in rats undergoing pelvic radiotherapy.Material and Methods: Fifty-six male Wistar albino rats were randomly allocated to four main groups. Group I, left colon resection and primary anastomosis; Group II, post-anastomotic amniotic membrane; Group III, preoperative radiotherapy; Group IV, preoperative radiotherapy and amniotic membrane. Radiotherapy was administered under general anesthesia eight and four days prior to surgery at a total of 20 Gy. In the first operation, all the rats underwent 1 cm left colon resection and primary anastomosis. The animals in each group were anesthetized to assess the clinical, mechanical, histologic, and biochemical parameters of anastomotic healing on the third and seventh postoperative days.Results: In the third day groups, anastomosis line bursting was observed in only one subject in those undergoing amniotic membrane wrapping(p0.05) and in all rats in those with no amniotic membrane wrapping. No statistically significant difference was observed in any of the parameters on the histopathological examination of the day 3 groups. The amounts of granulation tissue and fibroblast were significantly higher in the post-anastomotic amniotic membrane group (p0.05), and the macrophage amount was seen to be significantly low in both amniotic membrane groups (p0.05). Conclusion: Amniotic membrane application on the anastomoses in the intestines, either with or without radiotherapy, may contribute to wound healing by positively affecting the anastomosis health.