Cimen, Orhan; Ağaoglu, Nazım; Peker, Kemal; Kerim Aslan, Mithat; Soyturk, Mehmet; Eken, Huseyin; Demiryilmaz, Ismail; Yazıcı, Ahmet; Burak Cekic, Arif; Kocyigit, Sema

Background: Acute pancreatitis (AP) is a serious disease characterized by inflammation of the pancreas. Material/Methods: We prospectively investigated a total of 42 patients treated at Karadeniz Technical University Faculty of Medicine General Surgery Department with the preliminary diagnosis of AP from January 2010 to June 2011, and who underwent biochemical tests and magnetic resonance cholangiopancreatography (MRCP). Patient age, sex, amylase levels, and other biochemical parameters, as well as treatment type, complications, etiologic factors, morbidity rates, hospital length of stay, and Ranson scores, were included in the evaluation. Results: Our study population consisted of 24 women and 18 men. The serum amylase levels ranged between 146 and 3086 U/L (mean 1271.07 U/L). When patients were scored according to the Ranson scoring system, 3 (7.1%) patients had a Ranson score of 0, 10 (23.8%) patients had a score of 1, 15 (35.7%) patients had a score of 2, 11 (26.2%) patients had a score of 3, 2 (4.8%) patients had a score of 4, and only 1 (2.4%) patient had a score of 5. We found abnormal pancreatic duct morphology in 10.3% of the patients who had mild pancreatitis attacks and 33.3% of the patients who had moderate pancreatitis attacks. Although we observed a correlation between the Ranson score and pancreatic duct morphology, this relationship was not significant (P>0.05). Conclusions: Based on the results of our study, we believe that MRCP and MR are as effective as CT in the follow-up and treatment of acute pancreatitis.

Eken, Huseyin; Karagul, Servet; Buyukakıncak, Sercan; Cimen, Orhan; Sinan, Huseyin; Koca, Bulent; Bicer, Senol; Malazgirt, Zafer

Background: We aimed to compare the post-operative insulin resistance and early-term clinical outcomes of laparoscopic total extraperitoneal (TEP) repair and open mesh repair (Lichtenstein) in congenital-type inguinal hernias in young males. Material/Methods: A randomized, prospective, and double-blind study was planned. Twenty-six male patients with either type I or type II inguinal hernia according to Zollinger classification were operated on using the Lichtenstein technique or total extraperitoneal (TEP) technique. Insulin sensitivity measurement was performed twice on patients by using the hyperinsulinemic-euglycemic glucose clamp technique, once on the day before the operation and once 30 minutes postoperatively. We evaluated complications, pain, and life quality at 1 week and 1 month after surgery. Pain level was determined by visual analogue pain scale and life quality was determined by shortform 36 life quality assessment scales. Results: There was no difference between the Lichtenstein group M values (mean 4.91±2.25) and TEP group M values (mean 4.89±1.74) in terms of preoperative M values. There was a significant difference between Lichtenstein group M values (mean 3.60±2.34) and TEP group M values (mean 2.05±1.39) in terms of postoperative M values. Complication rates and visual analogue pain scale values of both groups were similar. In the short-form 36 life quality assessment scale, TEP group patients had higher scores in terms of emotional role at 1 week after surgery compared to the Lichtenstein group, but at 1 month after surgery we observed that the difference had disappeared. Conclusions: For small- and medium-sized indirect inguinal hernia repairs in young males, the Lichtenstein technique causes fewer injuries than the TEP technique in the short-term, but in the long-term both techniques have similar durations of improvement.