Bile duct injuries during laparoscopic cholecystectomy: a 1994-2001 audit on 13,718 operations in the area of Rome.

BACKGROUND: Bile duct injuries (BDIs) during laparoscopic cholecystectomy (LC) still are reported with greater frequency than during open cholecystectomy (OC). METHODS: In 1999, a retrospective study evaluating the incidence of BDIs during LC in the area of Rome from 1994 to 1998 (group A) was performed. In addition, a prospective audit was started, ending in December 2001 (group B). RESULTS: In group A, 6,419 LCs were performed (222 were converted to OC; 3.4%). In group B, 7,299 LCs were performed (225 were converted to OC; 3.1%). Seventeen BDIs (0.26%) occurred in group A and 16 (0.22%) in group B. Overall, mortality and major morbidity rates were 12.1% and 30.3%, respectively, without significant differences between the two groups. CONCLUSIONS: The incidence and clinical relevance of BDIs during LC in the area of Rome appeared to be stable over the past 8 years and were not influenced by the use of a prospective audit, as compared with a retrospective survey.

Early gastric cancer: total gastrectomy vs. distal resection. Results of a study of 271 cases. The Italian Stomach Cancer Group (A.C.O.I.-I.S.C.G.).

Two hundred and seventy-one (271) patients with early gastric cancer from 26 different hospitals were examined in a retrospective study conducted by the I.S.C.G. (Italian Stomach Cancer Group). The patients were divided into two series: the first, comprising 234 patients with negative lymph nodes (Stage ITNM-UICC), had 5-year survival rates of 85%. The second group comprised 37 patients with positive lymph nodes (Stage III TNM-UICC) with a 72% five-year survival rate. Both results appear to be of great significance when compared with the five-year survival rate for advanced gastric cancer, namely 29.3%. As far as the difference between the late results of total gastrectomy and subtotal distal resection are concerned, the latter was associated with a higher five-year survival rate in the case of tumors located in the lower third and in the middle third of the stomach.

[Multicenter retrospective study of 3,024 patients operated on for stomach cancer in Italy. Epidemiology, surgical treatment and survival]. / Etude rétrospective pluricentrique de 3 024 patients opérés pour cancer de l'estomac en Italie. Epidémiologie, traitement chirurgical et survie.

This study presents the results achieved in 2,000 patients who underwent gastric resection and who had been selected from amongst 3,074 cases of gastric neoplasia included in the Retrospective Study of Carcinoma of the Stomach, carried out by the "Italian Stomach Cancer Group" of the Association of Italian Hospital Surgeons (ACOI). In terms of the UICC TNM classification, these patients consisted of 234 stage I patients, 494 stage II patients 1,011 stage III patients and 261 stage IV patients. The overall operative mortality was 7.1 percent. This was lower after subtotal distal resection. The long-term survival tended to fall in proportion with the stage of the illness, whereas the degree of the exeresis did not appear to have any impact. The overall survival at 5 years in the patients who survived the operation was 45%, that following distal resection was 54% and that after total gastrectomy was 33%. The survival rate in terms of the stage ranged from 86% for Early Gastric Cancers to 28% for the patients who underwent surgery at stage III i.e. when they had metastatic lymph nodes.