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Öğe Infections developing in patients undergoing livertransplantation: Recipients of living donors may be moreprone to bacterial/fungal infections(2020) Ünalp, Ömer Vedat; Türkeş, Ayşın Zeytinoğlu; Karasu, Zeki; Erol, Funda; Güler, Ezgi; Turhan, Kutsal; Turan, İlkerBackground/Aims: Despite surgical advances in liver transplantation and effective prophylactic strategies, posttransplant infections are the most important cause of morbidity and mortality. Diagnosis and management of infections because of developing immunosuppression is difficult and adversely affects mortality. This study aimed to review bacterial and fungal infections in patients after liver transplantation and to reveal the resistance rates.Materials and Methods: A total of 107 patients who underwent liver transplantation between January 2017 and February 2018 were evaluated retrospectively with regard to demographic characteristics, causes of transplantation, conditions that may lead to infection, postoperative infections, pathogens, and resistance patterns.Results: Of the 107 patients who underwent liver transplantation, 48 (44.8%) had an infection. Bacterial infections were detected in 41% of the patients, and fungal infections were found in 13%. When we compared living and cadaveric transplants in terms of infection development, these rates were found to be 53% and 33%, respectively (p=0.034). No statistically significant results could be obtained when evaluating conditions such as sex, presence of underlying primary disease, Model for End-Stage Liver Disease MELD score, diabetes status, total parenteral nutrition, and risk factors for infection.Conclusion: After liver transplantation, infections are often seen in the first month of the postoperative period. Knowing the most common pathogens and resistance states in this process reduces infection-related deaths by providing appropriate treatment regimens at the right time.Öğe Portal triad klempajının pankreas dokusu üzerine etkileri ve oktreotitin koruyucu etkisi(Ege Üniversitesi, 2007) Ünalp, Ömer Vedat; Zeytunlu, Murat[Abstarct Not Available]Öğe Şiddetli pankreatit ve tedavi yaklaşımları: Mevcut sınıflamalar yeterli mi?(2011) Ünalp, Ömer Vedat; Erol, Varlık; Yeniay, Levent; Demir, Batuhan; Çoker, AhmetGiriş ve Amaç: Akut nekrotizan pankreatit, akut pankreatitin en şiddetli formudur ve pankreatitin seyri sırasında parenkim nekrozunun geliştiği pankreatit tipidir. Bu çalışmada akut nekrotizan pankreatit nedeniyle cerrahi ve konservatif tedavi uygulanan hastalar RANSON VE APACHE II skorlama sistemleri eşliğinde değerlendirilerek, morbidite ve mortaliteye etkili faktörler ve skorlama sistemlerinin tedavi yönetimindeki etkinliğini araştırmayı amaçladık. Gereç ve Yöntem: Kliniğimizde 2005-2010 yılları arasında akut nekrotizan pankreatit tanısıyla takip ve tedavi uygulanan 39 hasta retrospektif olarak değerlendirildi. Hastaların morbidite ve mortalite risk oranları RANSON ve APACHE II skorlama sistemleri ile belirlendi. Bulgular: Operasyon uygulanan 13 hastadan 4’üne eksplorasyon + nekrozektomi, 6 hastaya drenaj kateteri yerleştirilmesi, 1 hastaya nekrozektomi + sol hemikolektomi + hartmann prosedürü, 1 hastaya nekrozektomi + sağ hemikolektomi + lahey mikulicz prosedürü, 1 hastaya nekrozektomi + sağ hemikolektomi + parsiyel ince barsak rezeksiyonu + ucuca anastomoz operasyonları uygulandı. Opere olan hastalardan 10’u (%77) mortal seyrederken, toplam mortalite sayısı 17 (%44) olarak belirlendi. Yirmi iki (%56) hasta şifa ile taburcu edildi. Sonuç: Nekrotizan pankreatitli hastaların tedavi yönetiminde ve cerrahi kararının alınmasında, sadece bilgisayarlı tomografi ve skorlama sistemlerinden alınan değerlerle hareket etmektense hastaların klinik durumunu ve vital bulgularını ön planda tutmanın daha yararlı olacağı kanaatindeyiz.Öğe Solid pseudopapillary neoplasms of the pancreas:Case series with a review of the literature(2020) Ünalp, Ömer Vedat; Karaca, Avni Can; Akpınar, Göksever; Aydın, Ahmet; Oruç, Nevin; Uguz, Alper; Çoker, AhmetBackground/Aims: The solid pseudopapillary neoplasms are quite rare tumors of the pancreas, comprising roughly 1-2% of all pancreatic neoplasms. It has a low malignant potential and usually affects young females. Despite increasing number of articles in the last decade, there is still debate on the pathogenesis, malignant potential and optimal surgical strategy for the solid pseudopapillary neoplasms. Materials and Methods: Medical recordings of 326 patients who were operated due to pancreatic mass were retrospectively analyzed. Patient demographics, presenting symptoms, surgical and pathologic characteristics of the tumor, postsurgical course, long-term survival, and other relevant data were extracted from patients’ charts.Results: Majority of the patients were female in consistency with the classic data in the literature. All the patients underwent curative intent resections. Tumors were commonly localized in the tail of the pancreas making distal pancreatectomy the most commonly performed surgical procedure. Mean tumor diameter was 5.8 centimeters with tumor sizes ranging from 1 to 19 cm.Conclusion: The solid pseudopapillary neoplasms of the pancreas is a rare tumor with low malignant potential, which is more common in females of reproductive age, with abdominal pain being their most common presentation. The short-term outcomes in patients following surgical R0 resection are excellent. However, proximal placement of the tumor and female gender may have slightly worse prognosis. We hope that our findings from a series of patients represent a contribution to the existing literature on SPN, and authors declare their willingness to provide further details for future meta-analyses.
