Assuntos
Abscesso Abdominal/etiologia , Tumores do Estroma Gastrointestinal/complicações , Abscesso Abdominal/diagnóstico , Abscesso Abdominal/microbiologia , Abscesso Abdominal/cirurgia , Idoso , Biópsia , Endoscopia Gastrointestinal , Enterococcus/isolamento & purificação , Feminino , Gastrectomia , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Pancreatectomia , Pseudomonas aeruginosa/isolamento & purificação , Esplenectomia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND AND OBJECTIVES: In this study, the value of the serum tumor markers carcinoembryonic antigen (CEA), CA 19-9, and CA 125 was assessed in the differential diagnosis of benign and malignant pancreatic diseases with and without obstructive jaundice. METHODS: Serum levels of CEA, CA 19-9, and CA 125 were measured by immunoradiometric assay before the treatment in 123 patients with pancreatic carcinoma and 58 patients with a benign pancreatic disease. RESULTS: The sensitivity of CEA, CA 19-9, and CA 125 in the diagnosis of pancreatic carcinoma was 39.0%, 81.3%, and 56.9%; and specificity was 91.4%, 75.9%, and 77.6%, respectively. Although there was no significant difference between the CA 19-9 positivity ratios of the jaundiced (84.3%) and nonjaundiced (73.5%) patient subgroups of the pancreatic carcinoma, this ratio was significantly higher in the jaundiced subgroup (64.7%) than the nonjaundiced subgroup (7.3%) of the benign pancreatic diseases (P < 0.001). The CEA and CA 125 positivity ratios of jaundiced and nonjaundiced subgroups of patients with benign and malignant pancreatic diseases were not significantly different. CONCLUSIONS: In the differential diagnosis of pancreatic carcinoma from benign pancreatic diseases, CA 19-9 can be useful in the nonjaundiced patients, whereas CA 125 provides a limited contribution in jaundiced patients.
Assuntos
Biomarcadores Tumorais/sangue , Antígeno Ca-125/sangue , Antígeno CA-19-9/sangue , Antígeno Carcinoembrionário/sangue , Icterícia Obstrutiva/complicações , Pancreatopatias/diagnóstico , Diagnóstico Diferencial , Humanos , Ensaio Imunorradiométrico , Pancreatopatias/complicações , Neoplasias Pancreáticas/diagnóstico , Pancreatite/diagnóstico , Estudos Prospectivos , Sensibilidade e EspecificidadeRESUMO
Laparoscopic splenectomy (LS) is a preferred choice, especially for hematologic diseases. We present the advantages of the use of LigaSure (energy-based equipment that works by applying a precise amount of bipolar energy and pressure to the tissue, achieving a permanent seal) for achieving a precise hemostasis, thus making the LS easier. We have performed LS using LigaSure on 10 patients (4 female, 6 male; mean age, 36 years [range, 16-58]) between December 2002 and August 2003. All patients had ITP. There were no conversion to open surgery. Mean dimensions of spleens were 99 x 49 mm (range, 85 x 36-118 x 60). Intraoperative blood loss was no more than 100 mL in any patients (range, 20-100; mean, 60). The average operative time was 93 minutes (range, 60-155). There were no complications in the postoperative period. The average postoperative stay was 4.3 days (range, 3-7). LS using LigaSure is a safe and time-sparing procedure with almost no complications in this small initial series.
