A novel study, textbook outcome in adrenalectomy: retrospective observational study in an endocrine surgical unit.

Textbook outcome is a multidimensional quality management tool that uses a set of traditional surgical measures to reflect an "ideal" surgical result for a particular pathology. Retrospective study of all patients undergoing scheduled for adrenal tumors surgery at an endocrine surgery unit from January 2010-December 2022. The definition of Textbook Outcome were: R0 resection, no Clavien-Dindo ≥ IIIa complications, no prolonged stay (< P75), no readmissions, and no mortality in the first 30 days. The main objective was to analyze the rate of Textbook Outcome obtained. One hundred and five patients were included in the study. Textbook Outcome was achieved in 71.4%. Surgical approach (p < 0.001), Charlson scale (p = 0.031), American Society of Anesthesiologists Classification (p = 0.047) and surgical time (p < 0.001) were all significantly associated with the achievement of Textbook Outcome. The laparoscopic approach was associated as an independent factor with obtaining Textbook Outcome (OR:5.394; p = 0.016), as was surgical time (OR:0.986; p = 0.004). Textbook Outcome is a novel, useful, easy-to-interpret tool for measuring results in adrenal surgery. The laparoscopic approach is associated with a higher rate of "ideal" surgical results. The study was registered in the public accessible database clinicaltrials.gov with the ClinicalTrials.gov ID: NCT05888753.

[Ectopic pancreas]. / Páncreas ectópico.

We describe ten cases of ectopic pancreas operated on in the Hospital General Universitario, Alicante, between 1970 and 1994. Average age of patients was 47.7 (range 3-75); five men and five women. In four cases there was associated digestive tract bleeding, three had chronic gastroduodenal ulcers, two pancreaticobiliary disease, and one suprarenal abnormalities. In four cases the ectopic gland was found in the gastric antrum; in four cases in the duodenum and in the remaining two cases in the first jejunal loop. Average diameter was 2.3 cm (range 0.6-6). In six cases complete pancreas tissue was found, in three an exocrine pancreas and in one a purely endocrine pancreas. In two patients the presence of the choristoma and the clinical findings due to erosion of the subjacent mucosa may be related. In one case the finding of cholelithiasis, intradiverticular papilla, and periampullar ectopia together with clinical features of recurrent pancreatitis may also be linked. In the remaining seven cases no relationship was found between the ectopic pancreas and the clinical features. Our series suggest that simple resection is best to avoid complications.

[Granular cell tumor of the bile duct: an infrequent location]. / Tumor de células granulosas en la vía biliar: una localización poco frecuente.

We report a case of granular cell tumor of the cystic duct. We have found only 47 such tumors of the biliary tract reported in the literature. Main symptoms at presentation are abdominal pain or obstructive jaundice. The clinical diagnosis is often difficult and the differential diagnosis is established with other more frequent conditions, including malignant neoplasms. Surgical excision is curative.

[The prevalence of the surface antigen of the hepatitis B virus (HBsAg) in pregnant women in Alicante]. / Prevalencia del antígeno de superficie del virus de la hepatitis B (HBsAg) en gestantes de Alicante.

To assess the prevalence of the hepatitis B virus carrier status in pregnant women from the population of Alicante and to evaluate the need of screening studies in future programs of attention to pregnant women, 550 women at the final stage of their pregnancies who were admitted to the Alicante Hospital were evaluated with a questionnaire and the determination of specific markers. Our results disclose a lower prevalence (0.54%) than other studies; it was always associated with risk groups and indicators of high infectiousness were absent. Therefore, before other results are available, screening for the carrier state in all pregnant women does not appear justified except in risk groups. These results are limited to the city of Alicante, where most women attend the Hospital at the final stage of their pregnancies.