Gastrin: a new branch of the gastropancreatic axis that can explain the effect of sleeve gastrectomy on glucose metabolism.

BACKGROUND: Among bariatric techniques, sleeve gastrectomy (SG) stands out owing to its efficiency. The role of the stomach as a secretory organ of many substances, such as gastrin, related to insulin secretion is well known. Gastrin induces insulin release in isolated pancreatic islets, limiting somatostatin-14 intraislet release, and has been associated with blood glucose level improvement in diabetic models after SG. SG involves gastric resection along the greater curvature. This study aimed to determine the role of gastrin in glucose metabolism improvement after SG with the aid of the gastrin antagonist netazepide. METHODS: In 12 sham-operated, 12 SG-operated, and 12 SG-operated/netazepide-treated Wistar rats, we compared medium- and long-term plasma insulin, oral glucose tolerance test (OGTT) results, and plasma gastrin levels. In addition, gastrin expression was assessed in the gastric remnant, and the beta-cell mass was measured. RESULTS: SG induced a medium-term elevation of the insulin response and plasma gastrin levels without modification of the OGTT results. However, long-term depletion of the insulin response with elevated OGTT areas under the curve and plasma gastrin levels appeared after SG. Netazepide prevented the SG effect on these parameters. Gastrin tissue expression was greater in SG animals than in SG/netazepide-treated or control animals. The beta-cell mass was lower in the SG group than in the control or SG/netazepide group. CONCLUSION: Gastrin plays a central role in glucose improvement after SG. It stimulates a medium-term strong insulin response but also causes long-term beta-cell mass depletion and a loss of insulin response. These effects are prevented by gastrin antagonists such as netazepide.

Lymphoepithelial cyst of the pancreas.

Within pancreatic cysts, the lymphoepithelial variant is considered a highly atypical condition with few reported cases in the literature. Following a case managed in our hospital, we aim to shed more light on this entity as an incidental finding, providing a temporal description until its excision, along with radiological, surgical, and histological images.

Partial splenectomy for a giant epidermoid cyst of the spleen.

The splenic epidermoid cysts are rare benign tumors, and a definitive treatment remains unclear. Although some spleen-preserving approaches have been reportedly used, splenic cyst recurrence usually occurs in true cyst cases, wherein the cyst is incompletely removed. In our case, partial splenectomy was performed and the giant cyst was completely removed.

Uterine leiomyosarcoma metastasis to the pancreas: report of a case and review of the literature.

INTRODUCTION: Uterine leiomyosarcoma is an aggressive malignant tumor that often leads to metastatic dissemination, generally in the lungs, liver, brain, and bones. Despite the fact that pancreatic neoplasms spread easily, the pancreas is not a usual target organ from other neoplasms. CASE REPORT: We present a rare case of metastasis to the pancreas from uterine leiomyosarcoma treated with segmental resection with no recurrence at this stage. A review of the literature is later presented showing no similar case to what has been reported. DISCUSSION: Surgical resection of unique pancreatic metastases is a safe practice. An increase in the survival rate has been demonstrated after resection of metastases from renal cell carcinoma, although it has not been proved with metastases from other locations. Further trials are needed.

Real anal leiomyoma: a case report.

Leiomyoma of the rectum and anal canal is an unusual benign mesenchymal neoplasm that originates from smooth muscle cells. We describe the clinical presentation, MRI findings, and surgical treatment of a rare case of perianal leiomyoma confirmed by immunohistochemistry. We also report a review of the world's literature on the subject.

Intraabdominal bronchogenic cyst.

INTRODUCTION: Bronchogenic cyst is pathology of the respiratory track. It consists of a defect during the embryological development of the tracheobronchial tree. Most common presentation is as a solid or cystic mass located in mediastinum, and it is usually diagnosed in relation to respiratory problems or recurrent infections in children. In adulthood, it is a rare pathology, and its diagnosis is usually incidental. CASE REPORT: We present a case of a patient with a paraesophageal cystic mass suggestive of intraabdominal esophageal duplication cyst but, after the histopathological examination, was discovered to be a bronchogenic cyst, something extremely rare as in most cases of subdiaphragmatic location; bronchogenic cysts appear as retroperitoneal lesions. DISCUSSION: After we review the current literature, surgical extirpation appears to be the treatment of choice due to potential complications, and laparoscopic approach is a feasibily and safe procedure for this pathology up to date.