Abdil Cem İbiş

Financial Aspects of Bile Duct Injuries

Background Major bile duct injury is the most worrisome complication of cholecystectomy. There is no detailed data about the incidence or treatment-related costs of bile duct injuries in Turkey. We aimed to determine prevalence and therapeutic costs of patients with major biliary duct injuries managed in our department, and further estimate a projection of these parameters at the national level. Material/Methods All patients admitted due to bile duct injury during cholecystectomy from 2011 to 2014 were included. Healthcare costs were calculated by summing of their all treatment-related costs in Istanbul Medical Faculty. We collected 2014–2015 data on number of patients diagnosed with cholecystitis in Turkey, the number of cholecystectomies, and the number of the interventions performed following these initial surgeries, which were obtained from the Turkish Social Security Institution. Results Forty-nine patients were enrolled and bilioenteric diversion was performed in 39 patients: 20.4% of patients had Bismuth II, 38.8% had Bismuth III, and 40.8% had Bismuth IV biliary stricture. Comparison of stricture types with total costs, days of hospitalization, and outpatient clinic costs revealed significant differences. Mean total cost of corrective surgeries was 9199 TRY. We estimated that 1.5% to 2.4% of patients who underwent cholecystectomy in Turkey have bile duct injury (including 0.3% with major bile duct injury). Conclusions New preventive strategies should be used to avoid bile duct injuries, which have a huge financial impact on the national economy.

Abdominal Tuberculosis Mimicking Peritoneal Carcinomatosis

Abdominal tuberkuloz nadir bir durumdur ve bulgulari cogu zaman nonspesifiktir. Bircok degisik patolojik durumu taklit edebilir. Abdominal tuberkuloz tum gastrointestinal sistemi, mezenteri ve peritonu tutmasinin yani sira, solid organlar olan dalak, karaciger ve pankreasida tutabilmektedir. Karin icinde kitle nedeniyle ameliyat edilen ve ameliyat sirasinda makroskopik olarak peritonitis karsinomatoza tanisi dusunulen 42 yasindaki kadin hastaya iliskin olgu literatur bilgileri esliginde sunuldu.

Extra-abdominal Agressive Fibromatosis Presenting As An Intrathoracic Tumor

Fibroz doku kaynakli tumorler toraksta ve mediastinumda nadir olarak gorulmekte ve rapor edilmektedirler. Biz burada, agresif fibromatozisin, toraks ici dokulardan kaynaklanan nadir bir formunu bildirmek istedik. Otuz alti yasinda bayan hasta hastanemize sol gogus agrisi ve sikisma hissi ile basvurdu. Cekilen PA grafi ve toraks bilgisayarli tomografisinde, sol toraks alt kismini ucte iki oraninda dolduran dev kitle goruldu. Bunun uzerine hastaya sol yedinci interkostal araliktan yapilan torakotomi ile genis rezeksiyon uygulandi. Tumor patolojisi 20x15x15 cm capinda agresif fibromatozis olarak geldi. Hasta 15 aydir takip altinda ve kontrollerinde yineleme gorulmedi.