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    Early laparoscopic cholecystectomy for acute cholecystitis
    (TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2009) Tekin, Ahmet; Kucukkartallar, Tevfik; Belviranli, Metin; Vatansev, Celalettin; Aksoy, Faruk; Tekin, Sakir; Kartal, Adil
    BACKGROUND The aim of this study, was to assess the clinical results of treatment by laparoscopic cholecystectomy (LC) in patients with acute cholecystitis. METHODS Between 1994 and 2006, LC was performed in 3876 patients in Selcuk University Meram Medicine Faculty. The clinical, biochemical, radiologic, and operative data of 182 (101 F, 81 M) consecutive patients with acute cholecystitis operated 3 days after the onset of symptoms were analyzed retrospectively to determine the complications and morbidity after operation. RESULTS The conversion rate was 31 (17.03%) in acute cholecystitis. Postoperative length of stay was found as 4 days in the successful LC group and 7 days in the conversion group. For acute cholecystitis, we found a statistical difference between the successful LC group and the conversion group in terms of length of postoperative hospitalization time and gallbladder wall thickness. We identified the following factors as associated with conversion: male gender, pericholecystic collection L seen on ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm. CONCLUSION LC is a safe approach in selected patients with acute cholecystitis. Male gender, pericholecystic collection seen on ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm are associated with a higher risk of conversion to open surgery.
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    Internal herniation as a major cause of intestinal obstruction
    (KARGER, 2008) Tekin, Ahmet; Kuecuekkartallar, Tevfik; Aksoy, Faruk; Vatansev, Celalettin; Belviranli, Metin; Tekin, Sakir; Yol, Serdar
    Objectives: To evaluate internal herniation as a rare cause of intestinal obstruction. Materials and Methods: Files of 18 cases, operated due to internal herniation between 2000 and 2006 at Selcuk University, Meram School of Medicine, General Surgery Department, were reviewed retrospectively. Sixteen patients (88.8%) were male (mean age: 58.2 years; range: 42-67) and 2 were female (mean age: 56.5 years; range: 52-61). Cases were grouped according to the location of internal herniation, and the clinical findings and applied treatment strategies were evaluated. Results: All patients were taken into surgical operation after preoperative preparations were completed. Findings were as follows: 6 cases of paraduodenal internal herniation, 4 of internal herniation through a defect in the terminal mesoileum, 2 of herniation through a defect in the falciform ligament, 2 of herniation through a defect in the omentum majus, 1 of herniation to the recessus over the bladder, 2 of herniation through a defect in the transverse mesocolon and 1 iatrogenically caused internal herniation through a defect in the mesojejunum. Conclusion: In an adult patient with findings of intestinal obstruction, diagnosis is difficult. Most cases presented to date are incidental findings during laparotomy, and surgical treatment is necessary. Copyright (c) c 2008 S. Karger AG, Basel.
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    Use of chorioamniotic membrane instead of bogota bag in open abdomen: How I do It?
    (W J G PRESS, 2008) Tekin, Sakir; Tekin, Ahmet; Kuecuekkartallar, Tevfik; Cakir, Murat; Kartal, Adil
    It is one of the most important problems for general surgeons to decide which operation should be undertaken on patients with intra-abdominal infection, especially those with concomitant abdominal hypertension. Recentlly, closure techniques using prosthetic meshes in order to retain abdominal tension and to control sepsis have become very popular for patients with abdominal sepsis and hypertension. We used chorioamniotic membrane instead of plastic material to cover the open abdomen. We conclude that human chorioamniotic membrane prepared under sterile conditions may be an alternative to conventional plastic bags in daily practice, for preventing serosal erosion and fistulas in patients undergoing open abdominal surgery.