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Öğe Amyand hernia(2018) Kocaaslan, Hüseyin; Ozgor, Dıncer; Koc, Suleyman; Ates, Mustafa; Dirican, AbuzerÖğe Comparison of Two Pancreatic Anastomosis Techniques in terms of Postoperative Complications After Pancreaticoduodenectomy(Aves, 2021) Koc, Suleyman; Dirican, Abuzer; Soyer, Vural; Ara, Cengiz; Yologlu, Saim; Yilmaz, SezaiObjective: in this retrospective study, we compared the postoperative complications by using both the Clavien-Dindo classification and the Revised 2016 International Study Group on Pancreatic Surgery (ISGPS) classification methods after pancreaticoduodenectomy. Materials and Methods: The data of patients were retrospectively reviewed. Pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) were performed on 41 and 40 patients, respectively. The patients were assigned into two groups for anastomosis types and compared with each other according to postoperative complications. The postoperative follow-up period of the patients was limited to 90 days. Results: No significant difference was detected between the two groups in terms of gender (P = 581) and age (P = .809). According to the Clavien-Dindo classification system, grade I complication rates were 29.3% and 35.0% in. PJ and PG groups. respectively. Also, grade 2 complication rates were 34.1% and 325% in PJ and PG groups, respectively. Besides, grade 3B complication rates were 9.8% and 17.5% in PJ and PG groups, respectively. No grade 3A, grade 4A, and grade 4B complications were detected in both groups. But, grade 5 complications rates were 2.4% and 5.0% in 11 and PG groups, respectively. Based on the ISGPS classification system, the pancreatic fistulas were classified. The biochemical leak rates were calculated as 26.8% and 37.5% in PJ and PG groups, respectively. The rates were 14.6% and 10% in PJ and PG groups, respectively, for grade B complications. Also, grade C complication rates were 9.75% and 115% in. PJ and PG groups, respectively. No statistically significant differences were detected between the two groups for postoperative complications. Conclusion: The evidence from this retrospective study suggests that there is no difference between the two types of pancreatic anastomosis techniques (PJ or PG) in terms of the rate of postoperative complications.Öğe Graft-versus-Host Disease after Liver Transplantation: Comprehensive Literature Review(Wiley-Blackwell, 2012) Yilmaz, Mehmet; Akbulut, Sami; Ersan, Veysel; Koc, Cemalettin; Koc, Suleyman; Yilmaz, Sezai[Abstract Not Available]Öğe Hepatic Venous Outflow Obstruction After Living-Donor Liver Transplant: Single Center Experience(Baskent Univ, 2021) Koc, Suleyman; Akbulut, Sami; Soyer, Vural; Yilmaz, Mehmet; Barut, Bora; Kutlu, Ramazan; Yilmaz, SezaiObjectives: In this study, we share our approach for care of patients with hepatic venous outlet obstruction after living-donor liver transplant. Materials and Methods: We retrospectively examined the demographic, clinical, and radiologic data of 35 patients who developed hepatic venous outlet obstruction after living-donor liver transplant. Patients were subgrouped on the basis of onset (8 patients with early onset [< 30 days post-transplant] and 27 patients with late onset [>= 30 days posttransplant]) and postoperative survival (24 survivors, 11 nonsurvivors). Results: Patients ranged in age from 1 to 61 years (24 adults and 11 children). All adult patients had undergone right lobe living-donor liver transplant. In the pediatric group, 8 had undergone left lateral segment and 3 had undergone left lobe living-donor liver transplant. Nineteen adult patients and all 11 pediatric patients underwent hepatic venous reconstruction, with all procedures based on common large-opening drainage models using various vascular graft materials. Development of hepatic venous outlet obstruction occurred at mean posttransplant day 233 +/- 298.5 in the adult patients and mean posttransplant day 139 +/- 97.8 in the pediatric patients. After development of obstruction, the patients underwent 1-6 sessions (1.5 +/- 1.1 sessions) of balloon angioplasty. After the first balloon angioplasty procedure, 25% of the adults and 36.3% of the pediatric patients developed recurrence. The early-onset and late-onset subgroups showed statistically significant differences in serum albumin (P=.01), underlying causes (P<.001), time from transplant to obstruction (P=.02), and time from transplant to last visit (P=.02). The survivor and nonsurvivor subgroups showed statistically significant differences in total bilirubin (P=.03) and time from transplant to last visit (P=.03). Conclusions: Common large-opening reconstruction minimizes hepatic venous outlet obstruction development after living-donor liver transplant. Balloon angioplasty and/or stenting is almost always the first option in the care of this complication.Öğe Hepatoprotective effects of N-acetylcysteine on liver injury by irisin upregulation and oxidative stress reduction in diabetic rats(Springeropen, 2023) Erdogan, Mehmet Mustafa; Erdogan, Mehmet Ali; Koc, Suleyman; Yalcin, Alper; Turk, Ahmet; Yetkin, Esra AkkusBackgroundThe current study aimed to investigate the oxidative stress in rat liver with diabetes mellitus (DM) as well as the protective effects of N-acetylcysteine (NAC) on irisin expression.MethodsTwenty-eight male Wistar rats were divided into four groups, 7 rats in each group, and 30-day regimens of experimental or control groups. NAC-treated group is as follows: 100 mg/kg once daily was administered intraperitoneally (i.p.). Diabetes-induced group is as follows: single-dose intraperitoneal injection of streptozotocin (STZ) (50 mg/kg) was used to induce DM in overnight fasting Wistar rats. By determining blood glucose concentration in STZ-induced rats 72 h after injection of STZ, DM was assessed. DM + NAC group is as follows: STZ-induced DM plus NAC is described previously. On the 30th day of the experiment, liver samples were collected after fasting and anesthesia. Biochemical analyses were performed to measure total antioxidant status (TAS), total oxidant status (TOS), and malondialdehyde (MDA) levels. Each liver sample was weighed and then prepared for histopathologic evaluation by light microscopy.ResultsThere was a statistically significant decrease in TAS levels and an increase in TOS and MDA levels in the DM group compared to the control group. In contrast, TOS and MDA levels were found significantly decreased, and TAS levels increased in the serum and liver tissues of the DM + NAC group compared to the DM group. Liver samples were also used for histopathological examination using hematoxylin-eosin and immunohistochemical staining. STZ-induced liver damage was detected as oxidative stress, increased irisin immunoreactivity, sinusoidal dilatation, and hepatocyte degeneration. In the DM + NAC group, it was observed that NAC significantly reduced the aforementioned histopathological changes due to STZ.ConclusionIn the early period of diabetes, due to the antioxidant properties of irisin related to the sudden response of liver tissue to oxidative stress, it is thought that the immunoreactivity in the tissue increases in the early period. As a result, NAC in diabetic rat liver tissue was found to suppress oxidative damage and irisin immunoreactivity.Öğe Intraoperative Vasculer Complications in Living Donor Right Hepatectomy(Lippincott Williams & Wilkins, 2015) Dirican, Abuzer; Soyer, Vural; Sarici, Baris; Ates, Mustafa; Ozdemir, Fatih; Koc, Suleyman; Yilmaz, Sezai[Abstract Not Available]Öğe Life-Threatening Near-Miss Complications of Donor in Living Donor Liver Transplantation(Lippincott Williams & Wilkins, 2015) Onur, Asim; Dirican, Abuzer; Soyer, Vural; Sarici, Baris; Koc, Suleyman; Ates, Mustafa; Koc, Cemalettin[Abstract Not Available]Öğe Management of Hepatic Venous obstruction after Pediatric Living Donor Liver Transplantation at Liver Transplantation Institute of Inonu University.(Wiley-Blackwell, 2014) Yilmaz, Mehmet; Ozdemir, Fatih; Koc, Suleyman; Kutlu, Ramazan; Ince, Volkan; Isik, Burak; Ara, Cengiz[Abstract Not Available]Öğe A pancreatic pseudopapillary tumor enucleated curatively(Elsevier Sci Ltd, 2015) Karakas, Serdar; Dirican, Abuzer; Soyer, Vural; Koc, Suleyman; Ersan, Veysel; Ates, MustafaINTRODUCTION: Pseudopapillary tumors (PPT) of the pancreas are very rare, comprising 0.3-2.7% of all pancreatic tumors, and they occur mostly in young women. Generally, they are benign, but in rare cases they can enlarge, invade adjacent organs, and metastasize distantly. Radiological assessments and biochemical markers are important for diagnosing tumor characteristics. The main treatment is tumor resection. PRESENTATION OF CASE: An 18-year-old female was referred to our department suffering from abdominal discomfort and upper quadrant abdominal pain. Abdominal computed tomography (CT) revealed a 6-x5-cm mass between the pancreatic head and right adrenal gland (Fig. 1). The histological assessment was a solid PPT of the pancreas with intact surgical borders. DISCUSSION: PPT are very rare, comprising approximately 5% of cystic pancreatic tumors and similar to 1% of exocrine pancreatic neoplasms and present mainly during the second and third decades of life. PPTs are usually indolent tumors. As such, they tend to produce vague nonspecific symptoms or may be detected incidentally on imaging. Complete surgical resection (R0) is the most effective therapy for PPT. CONCLUSION: Although PPT is a very rare, benign tumor, it has the potential to metastasize to adjacent and distant organs. Consequently, they should be detected early, so that they can be treated surgically before malignant conversion. (C) 2015 The Authors. Published by Elsevier Ltd. on behalf of Surgical Associates Ltd.Öğe Urgent Liver Transplantation for Amanita Phalloides Caused Acute Liver Failure(Wiley-Blackwell, 2014) Dirican, Abuzer; Yilmaz, Mehmet; Baskiran, Adil; Koc, Suleyman; Ates, Mustafa; Ara, Cengiz; Kayaalp, Cuneyt[Abstract Not Available]Öğe Use of the Right Lobe Graft With Double Hepatic Arteries in Living-Donor Liver Transplant(Baskent Univ, 2022) Cakir, Tugrul; Sabuncuoglu, M. Zafer; Soyer, Vural; Sarici, Baris; Koc, Suleyman; Onur, Asim; Unal, BulentObjectives: We aimed to examine management of double hepatic artery reconstruction in patients under going living-donor liver transplant. Materials and Methods: Between January 2002 and June 2014, one thousand thirty-six living-donor liver transplants were performed at the Liver Transplant Institute of Malatya Inonu University. Living liver grafts with a single hepatic artery were used in 983 living-donor liver transplants, while grafts with double hepatic artery branches were used in 53 living-donor liver transplants. All of the liver grafts with double hepatic artery branches were right lobe grafts. Hepatic artery anastomosis technique and the other medical data of recipients who used grafts with double hepatic arteries were analyzed retrospectively. Results: A double hepatic artery anastomosis was created in 43 recipients, while a single anastomosis was created in the remaining 10 because of ligation of the nondominant hepatic artery branch. In 40 recipients, double hepatic artery branches in the graft were anastomosed with the recipient's right and left hepatic artery. In the remaining 3 recipients, double hepatic artery branches in the graft were anastomosed with the recipient's right hepatic artery and large segment 4 hepatic arteries. Postoperative complications related with hepatic artery anastomoses developed in 3 recipients: hepatic artery thrombosis (n = 1), hepatic artery aneurysm (n = 1), and hepatic artery stenosis (n = 1). A recipient with hepatic artery aneurysm immediately underwent a retransplant. A recipient with a hepatic artery thrombosis relapsed and required retransplant, which was treated with thrombectomy on postoperative day 10. A recipient with hepatic artery stenosis was followed conservatively. In our series, the incidence of complications related with double hepatic artery anastomosis was found to be 6.9%. Conclusions: According to our experiences, a double hepatic artery anastomosis does not increase the risk of hepatic artery thrombosis and can be performed safely by surgeons who are experienced with hepatic vascular reconstructions in a living-donor liver transplant recipient.
