[Cholecystosis: anatomo-clinical profile and therapeutic considerations]. / Le colecistosi. Profilo anatomo-clinico e considerazioni terapeutiche.

In the last 5 years 16 patients with cholecystosis were observed. In this period the most recent diagnostic and therapeutic techniques were used including ultrasound which allowed to diagnose 60% of adenomyomatosis, 33.3% of cholecystosis and 6.7% of gallbladder polyposis. In 6 cases a traditional open surgery cholecystectomy was performed, while the videolaparascopic approach was used in other 6 cases. Histologic examination always confirmed the preoperative diagnosis, however in one case a gallbladder cancer was histologically found; this case had been clinically diagnosed 9 years previously as adenomyomatosis. Therefore, our experience suggest, in agreement with others, that cholecystosis should be considered as a precancerous lesion.

[Current trends in therapeutic indications in gallstones]. / Attuali orientamenti nelle indicazioni terapeutiche per la calcolosi della colecisti.

In the last 3 years, 300 consecutive patients (110 men, 190 women) were treated for gallstone disease using either traditional open surgery or the video laparoscopic approach. The relative clinical data and results were compared and analysed. The Authors conclude that video laparoscopy presents a number of advantages such as minor costs, reduced pain, quick return to work, compared to traditional surgery, especially when correctly indicated.

[Ampullary and periampullary tumors]. / Tumori ampollari e periampollari.

Ninety-eight consecutive patients with ampullary and periampullary carcinoma diagnosed between 1983-1993 were studied retrospectively. Among these patients, 66 had a carcinoma of the head of the pancreas, 10 a carcinoma of the papilla of Vater, 8 a carcinoma of the duodenum, and 14 a carcinoma of the distal common bile duct. Resectability rate ranged from 12% to 90% according to the tumor location and histologic type. Palliative procedures such as laparotomy, biopsy and bilio-digestive bypasses were performed in 27 patients. Curative resections were performed in 24 cases: 20 pancreatoduodenectomies, 2 total pancreatectomies, 1 duodenectomy, 1 common bile duct resection. The results of the surgical treatment as well as mortality and morbidity rates were compared with those of different and larger series.

[Carcinoma of the extrahepatic bile ducts]. / Il carcinoma delle vie biliari extraepatiche.

In the last 5 years 25 patients (11 men, 14 women) with carcinoma of the extrahepatic biliary duct were studied. The most frequent localization of the carcinoma was the hepatic hilum. D.C.P. according to Whipple was possible only in one patient, while in 20 patients a palliative approach with external and internal biliary derivations was the choice. In the remaining 4 patients an explorative laparotomy with biopsy was performed. It is concluded that palliative resection allows for a better quality of life.

[The endoscopic treatment of postoperative stenoses of the upper digestive tract]. / Trattamento endoscopico delle stenosi post-operatorie del tratto digestivo superiore.

The authors compare their experience in dilatation of postoperative benign esophageal strictures. A total of 60 patients (37 males, 23 females: mean age 52), all with severe dysphagia, from January 1985 to September 1995, underwent endoscopic dilatation: 32 of these with Savary dilators and 28 with balloon dilators. Dilatation was effective in 93% in both groups. Two severe complications were recorded (1 heart attack and 1 perforation) in the group that underwent endoscopic dilatation with Savary dilators. During endoscopic management, pain recurred in 43% and 87% of cases after balloon or Savary dilatations, respectively. The authors believe balloon dilators are more effective, better tolerated and with less complications than Savary dilators. They reserve the management with Savary dilators to the extremely severe esophageal strictures.

[Cholecystectomy and colorectal cancer: a retrospective study of a sample of 285 operated patients]. / Colecistectomia e cancro colo-rettale: studio retrospettivo su un campione di 285 pazienti operati.

A review of 285 patients operated for colo-rectal cancer in order to evaluate cholecystectomy rate in their pathologic history is reported. A surprisingly high rate (9.47%) was registered also when compared with Literature data. Although not definitely conclusive for a positive correlation between cholecystectomy and colo-rectal cancer, the Authors believe that this study identifies a subgroup of patients potentially at risk for colo-rectal cancer. In these subjects a prophylactic, periodic colonoscopy could be useful.