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| 1 | An alternative surgical approach to a difficult case of Mirizzi syndrome: A case report and review of the literature显示文摘Mirizzi syndrome (MS) is an uncommon complication of gallstone disease and occurs in approximately 1% of all patients suffering from cholelithiasis. The syndrome is characterized by extrinsic compression of the common hepatic duct frequently resulting in clinical presentation of intermittent or constant jaundice. Most cases are not identifi ed preoperatively. Surgery is the indicated treat- ment for patients with MS. We report here a 71-year- old male patient referred to the surgical outpatient department for diffuse upper abdominal pain and mild jaundice (bilirubin rate: 4.2 mg/dL). Ultrasound examina- tion revealed a stone in the cystic duct compressing the common hepatic duct. The patient had a history of gas- trectomy for gastric ulcer 30 years ago. MRCP revealed a stone impacted in the cystic duct causing obstruction of the common hepatic duct by extrinsic compression. With these fi ndings the preoperative diagnosis was indicative of MS. At laparotomy a moderately shrunken gallbladder was found embedded in adhesions containing a large stone which was palpable in the common bile duct. The anterior wall of the body of the gallbladder was opened by an incision which extended longitudinally along the gallbladder towards the common bile duct. The stone measuring 3.0 cm in diameter, was then removed set- ting astride a large communication with the common bile duct. A Roux-en-Y cholecysto-choledocho-jejunostomy was performed. The subhepatic region was drained. The patient had an uneventful recovery. He was discharged eleven days after operation and remained well after a 30-mo follow-up. | Michael Safioleas Michael Stamatakos Constantinos Revenas Constantinos Chatziconstantinou Constantinos Safioleas Alkiviades Kostakis | 2006 | World Journal of Gastroenterology2006，12，34： | 13 |
| 2 | Clinical considerations and therapeutic strategy for sigmoid volvulus in the elderly:A study of 33 cases显示文摘AIM: To evaluate different types of treatment for sigmoid volvulus and clarify the role of endoscopic intervention versus surgery. METHODS: A retrospective review of the clinical presentation and imaging characteristics of 33 sigmoid volvulus patients was presented, as well as their diagnosis and treatment, in combination with a literature review. RESULTS: In 26 patients endoscopic detorsion was achieved after the first attempt and one patient died because of uncontrollable sepsis despite prompt operative treatment. Seven patients had unsuccessful endoscopic derotation and were operated on. On two patients with gangrenous sigmoid, Hartmann's procedure was performed. In five patients with viable colon, a sigmoid resection and primary anastomosis was carried out. Three patients had a lavage 'on table' prior to anastomosis, while in the remaining 2 patients a diverting stoma was performed according to the procedure of the first author. Ten patients were operated on during their first hospital stay (3 to 8 d after the deflation). All patients had viable colon; 7 patients had a sigmoid resection and primary anastomosis, 2 patients had sigmoidopexy and one patient underwent a near-total colectomy. Two patients (sigmoidectomy-sigmoidopexy) had recurrences of volvulus 43 and 28 mo after the initial surgery. Among 15 patients who were discharged from the hospital after non-operative deflation, 3 patients were lost to follow-up. Of theremaining 12 patients, 5 had a recurrence of volvulus at a time in between 23 d and 14 mo. All the five patients had been operated on and in four a gangrenous sigmoid was found. Three patients died during the 30 d postoperative course. The remaining seven patients were admitted to our department for elective surgery. In these patients, 2 subtotal colectomies, 3 sigmoid resections and 2 sigmoidopexies were carried out. One patient with subtotal colectomy died. Taken together of the results, it is evident that after 17 elective operations we had only one death (5.9%), whereas after 15 emergency operations 6 patients died, which means a mortality rate of 40%. CONCLUSION: Although sigmoid volvulus causing intestinal obstruction is frequently successfully encountered by endoscopic decompression, however, the principal therapy of this condition is surgery. Only occasionally in patients with advanced age, lack of bowel symptoms and multiple co-morbidities might surgical repair not be considered. | Michael Safioleas Constantinos Chatziconstantinou Evangelos Felekouras Michael Stamatakos Ioannis Papaconstantinou Anastasios Smirnis Panagiotis Safioleas Alkiviades Kostakis | 2007 | World Journal of Gastroenterology2007，13，6： | 10 |
| 3 | Walled-off pancreatic necrosis显示文摘Walled-off pancreatic necrosis (WOPN), formerly known as pancreatic abscess is a late complication of acute pancreatitis. It can be lethal, even though it is rare. This critical review provides an overview of the continually expanding knowledge about WOPN, by review of current data from references identified in Medline and PubMed, to September 2009, using key words, such as WOPN, infected pseudocyst, severe pancreatitis, pancreatic abscess, acute necrotizing pancreatitis (ANP), pancreas, inflammation and alcoholism. WOPN comprises a later and local complication of ANP, occurring more than 4 wk after the initial attack, usually following development of pseudocysts and other pancreatic fluid collections. The mortality rate associated with WOPN is generally less than that of infected pancreatic necrosis. Surgical intervention had been the mainstay of treatment for infected peripancreatic fluid collection and abscesses for decades. Increasingly, percutaneous catheter drainage and endoscopic retrograde cholangiopancreatography have been used, and encourag-ing results have recently been reported in the medical literature, rendering these techniques invaluable in the treatment of WOPN. Applying the recommended therapeutic strategy, which comprises early treatment with antibiotics combined with restricted surgical intervention, fewer patients with ANP undergo surgery and interventions are ideally performed later in the course of the disease, when necrosis has become well demarcated. | Michael Stamatakos Charikleia Stefanaki Konstantinos Kontzoglou Spyros Stergiopoulos Georgios Giannopoulos Michael Safioleas | 2010 | World Journal of Gastroenterology2010，16，14： | 5 |
| 4 | Primary melanoma of the gallbladder: Does it exist? Report of a case and review of the literature显示文摘与文学和这的结果研究的我们考察了的胆囊,看起来主要,的│恶性黑瘤的一个案例的场合是胆囊的主要黑瘤仍然是一个可疑医药实体。仅仅主要、变形的胆囊黑瘤的很少案例到目前为止被报导了,并且唯一的同意是外科是支柱治疗。为主要、变形的疾病的辅助化疗,激素疗法或免疫疗法的角色仍然保持未定义。 | Michail Safioleas Emmanouil Agapitos Konstantinos Kontzoglou Michail Stamatakos Panagiotis Safioleas George Mouzopoulos Alkiviadis Kostakis | 2006 | World Journal of Gastroenterology2006，12，26： | 2 |
| 5 | Benign multicystic peritoneal mesothelioma: A case report and review of the literature显示文摘Benign multicystic peritoneal mesothelioma (BMPM) is a rare tumor that occurs mainly in women in their reproductive age. The pathogenesis of BMPM is unclear and a controversy regarding its neoplastic and reactive nature exists. The biological behavior of BMPM is characterized by its slowly progressive process and high rate of recurrence after surgical resection. In addition this lesion does not present a strong tendency to transform into malignancy. Today approximately 130 cases have been reported. We here report a 62-year-old woman who had diffuse abdominal pain, nausea and vomiting. Physical examination revealed a painful mass in her upper abdomen. She reported a mild dehydration, but the vital signs were normal. Peristaltic rushes, gurgles and high- pitched tinkles were audible. Upright plain abdominal film revealed small bowel loops with air-fluid levels. She was diagnosed having an incarcerated incisional hernia that resulted in intestinal obstruction. The patient underwent surgery during which a cystic mass of the right ovary measuring 6 cm x 5 cm x 4 cm, four small cysts of the small bowel (1 cm in diameter) and a cyst at the retroperitoneum measuring 11 cm x 10 cm x 3 cm were found. Complete resection of the lesion was performed. The patient had an uneventful recovery and had no recurrence two years after surgery. | Michael C Safioleas Kontzoglou Constantinos Stamatakos Michael Giaslakiotis Konstantinos Safioleas Constantinos Kostakis Alkiviadis | 2006 | World Journal of Gastroenterology2006，12，35： | 2 |
| 6 | A- cute mesenteric ischaemia, a highly lethal disease with a devastating outcome 显示文摘 | Safioleas MC Moulakakis KG Papavassiliou VG | 2006 | Vasa2006，35，2： | 1 |
| 7 | Adrenal rupture after blunt abdominal trauma显示文摘 | Safioleas M Stamatakos M Safioleas C | 2008 | Chirurgia (Bucttr)2008，103，1： | 1 |
| 8 | Stapled chole- cystojejunostomy for palliative Ireatment of the malignant jaundice; an effective and feasible alterntive to hand-sewn method显示文摘 | Safioleas MC Moulakakis KG Safioleas CM | 2010 | Int ISurg2010，8，6： | 1 |
| 9 | Superficial parotidectomy under local anaesthesia显示文摘 | Safioleas M Stamatakos M Safioleas P | 2008 | Chirurgia (Bucur)2008，103，4： | 1 |
| 10 | Acute mesenteric ischaemia,a highly lethal disease with a devastating outcome显示文摘 | Safioleas MC Moulakakis KG Papavassiliou VG | | 0，，02： | 1 |
| 11 | Diagnostic evaluation andsurgical management ofhydatid disease of the liver 显示文摘 | Safioleas M Misiakos E Manti C | 1994 | World J Surg1994，18，6： | 1 |
| 12 | Acute rues- enteric ischaemia, a highly lethal disease with a devastating outcome显示文摘 | Safioleas MC Moulakakis KG Papavassiliou VG | 2006 | Vasa2006，35，2： | 1 |
| 13 | Cervical lymph node dissection in papillary thyroid cancer:current trends,persisting controversies,and unclarified uncertainties显示文摘 | Sakorafas GH Sampanis D Safioleas M | 2010 | Surg Oncol2010，19，2： | 1 |
| 14 | Coexistence of hypertrophic cardiomyopathy and fibromuscular dysplasia of the superior mesenteric artery 显示文摘 | Safioleas M Kakisis J Manti C | 2001 | N Engl J Med2001，344，17： | 1 |
| 15 | Surgical treatment of esophageal perforation 显示文摘 | Dosios T Safioleas M Xipolitas N | 2003 | Hepato-Gastroenterology2003，52，： | 1 |
| 16 | Palliative treatment for bile duct carcinoma显示文摘 | Safioleas M Mantas D Kakisis J | 2003 | Hepatogastroenterology2003，50，51： | 1 |
| 17 | A Case of Signet Ring Carcinoma of the Appendix: Dilemmas in Differential Diagnosis and Management显示文摘 | Aikaterini Mastoraki Ioannis S. Papanikolaou Dimitrios Kanakis Panagiotis Safioleas George Sakorafas Michael Safioleas | 2010 | Journal of Gastrointestinal Cancer2010，，2： | 1 |
| 18 | Hydatid disease of the liver: a continuing surgical problem 显示文摘 | Safioleas MC Misiakos EP Kouvaraki M | 2006 | Arch Surg2006，141，11： | 1 |
| 19 | Carcinoid tumors of the duodenum and the ampulla of Vater: Current diagnostic and therapeutic approach in a series of 8 patients. Case series显示文摘 | George C. Nikou Christos Toubanakis Konstantinos G. Moulakakis Spiridon Pavlatos Christos Kosmidis Elias Mallas Panayiotis Safioleas George H. Sakorafas Michael C. Safioleas | 2010 | International Journal of Surgery2010，，3： | 1 |
| 20 | Pancreatic cancer today显示文摘 | Safioleas MC Moulakakis KG | 2004 | Hepatogastroenterology2004，51，： | 1 |
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