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Öğe Brunner's gland mucus within the lamina propria of duodenal biopsies a potantial source of diagnostic error(1999) Gurer I.E.; Taskin V.; Genta R.M.; Haggit R.C.Cellular and mucinous debris may accumulate in the lumen of Brunner's glands and may be squeezed into the lamina propria of the duodenal villi by the trauma of a biopsy. In this location, this fibrillary, PAS - positive material may mimic the appearance of a distinct structure that can be misinterpreted as a nerve bundle, a hamartoma, the macrophages of Whipple's disease or other abnormalities. We discuss the appearance of Brunner's glands in normal duodenal biopsies with particular reference to this potentially misleading artifact.Öğe Endoscopic retrograd cholongiopancreatography results in diagnosis and therapy(1999) Hilmioglu F.; Yildirim B.; Karincaoglu M.; Aladag M.; Taskin V.; Kantarceken B.The use of diagnostic and therapeutic endoscopy for pancreaticobiliary disease has increased in recent years. Choledocholithiasis and malignant strictures are most common diagnosis on endoscopic retrograde cholangiopancreatography (ERCP). We reviewed our recent experience to assess the spectrum of procedures performed and their results. Medical records and radiographic examinations of 338 consecutive patients undergoing therapeutic ERCP were studied. The most common diagnoses were choledocholithiasis and malignant strictures. Successful cannulation was 91.7% and successful treatment was 90%.Öğe Gallbladder motility in asymptomatic gallstone, symptomatic gallstone and gallstone patients with biliary obstruction(1999) Taskin V.; Serbest S.; Hilmioglu F.Gallbladder motility in patients with asymptomatic gallstones (n:35,17M, 18F aged 33.80 years with a mean age of 53 years), patients with symptomatic gallstones (n:21, 5M, 16F, aged 24-70 years with a mean age of 45 years), and gallstone patients with biliary obstruction(n:15, 7M, 8F, aged 45-75 years with a mean age of 60 years) was measured by ultrasound (7.5 MHz). Fasting volume was determined prior to the test meal while postprandial measurements were taken 15 and 45 minutes after the test meal. Gallbladder fasting volume was greater in patients with biliary obstruction than in asymptomatic and symptomatic patients (32.6 ± 7.3 mL, 29.8 ± 7.4 and 23.9 ± 4.6 mL respectively, p > 0.05). Ejection fraction(15 min) was significantly lower in biliary obstruction cases than in asymptomatic and symptomatic patients (%8 ± 11.6, %47.6 ± 5.7 and %42.6 ± 5.3, respectively) and 45. min values remained significantly lower in these cases than in asymptomatic and symptomatic patients (%14.5 ± 10.8, %56 ± 5.5 and %57.9 ± 3, respectively). Based on the above results, it is concluded that, gallbladder motility may be impaired secondary to obstruction in patients with cholelithiasis.Öğe Needle knife papillotomy: Evaluation of safety and efficacy(1998) Taskin V.; Özyilkan E.; Hilmioglu F.The use of needle knife papillotomy (NKP) to achieve a selective bile duct cannulation is controversial. Despite this, many endoscopy centres have reported successful use of NKP when conventional techniques failed. In this prospective study, we assessed the safety and efficacy of NKP in eighty seven patients. In fifty nine of these patients, cholangiogram had failed and in twenty eight patients endoscopic sphincterotomy was unsuccessful because attempts at selective bile duct cannulation had failed. NKP was found successful in fifty one cases (58.6%) during the initial procedure and overall success rate was 79.3% after the subsequent session. There were complications in four cases (4.6%). There were no procedure related mortality and only two complications required surgical intervention. Based on our results, we consider that NKP is a helpful and safe procedure in patients in whom conventional techniques have failed.Öğe The prevalence of lymphoid follicles and intestinal metaplasia in Helicobacter pylori associated clinically significant gastroduodenal diseases(Turkish Society of Gastroenterology, 1999) Taskin V.; Gurer I.; Sari R.; Aydin A.; Yildirim B.; Aladag M.; Hilmioglu F.This study was designed to investigate the prevalence of lymphoid follicle formation and intestinal metaplasia in patients with Helicobacter pylori (H.pylori) associated clinically significant diseases. Biopsies from the antrum, corpus and fundus of stomach were obtained from 153 patients (non-ulcer dyspepsia, n:110; duodenal ulcer n:23, duodenal ulcer complicated by obstruction, n:20) with histopathologically proven H. pylori infection. All biopsies were examined for lymphoid follicle with germinal center and intestinal metaplasia. Lymphoid follicles were found in 44.5% of non-ulcer disypeptic patients, 70% of duodenal ulcer complicated by obstruction patients and in 47.8% of uncomplicated duodenal ulcer patients. In contrast, 15.5% of non-ulcer disypeptic patients and 20% of complicated duodenal ulcer patients had associated intestinal metaplasia while no intestinal metaplasia was observed in uncomplicated duodenal ulcer patients. Intestinal metaplasia incidence was not statistically different among the different gastroduodenal pathologies (P>0.05). However the incidence of lymphoid follicles was significantly higher in patients with complicated duodenal ulcer (P<0.05). Our results indicate that H.pylori infection in complicated duodenal ulcers are relatively chronic and aggressive compared to H.pylori infection in other gastroduodenal disorders.Öğe Therapeutic endoscopic retrograde cholangiopancreatography: Factors influencing complication risk(1999) Taskin V.; Hilmioglu F.The contributory factors in the development of complications following therapeutic endoscopic retrograde cholangiopancreatography (ERCP) are unclear. In the present study, we investigated whether factors such as the presence of Billroth II gastrectomy, the use of a needle knife for endoscopic papillotomy, the biliary-pancreatic pathology diagnosed with ERCP and the learning curve of the endoscopist have determining roles in complications seen following this procedure. Between May 1993 and August 1998, there were 278 patients in whom therapeutic ERCP was performed in our endoscopy unit. Of these cases, there were 18 in whom complications with therapeutic ERCP were reported. Complications were most frequently seen in patients with a diagnosis of papillary stenosis (14.2%), pancreatic cancer (11.1%), papillary tumor (7.7%), choledocholithiasis (7.5%), and cholangiocellular carcinoma (2.5%) (p = 0.640). The complication rates in patients with Billroth II gastrectomy and patients without Billroth II gastrectomy were found to be 9.1% and 6.4% respectively (p = 0.791). There was no statistically significant difference in rates of complications after the use of conventional or needle knife sphincterotomes (6.7% versus 6.1% respectively, p = 0.937). As the experience of the endoscopist increased during the study period, there was slight but a statistically insignificant decrease in the rate of complications in association with therapeutic ERCP (p = 0.082). No procedure related death was observed. In conclusion, all patients in whom sphincterotomy and pancreatic canal injection are performed require a skilled endoscopist and close follow-up.
