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ORAL PRESENTATIONS Turk J Surg 2017; 33 (Suppl.-1): 1-92 DOI: 10.5152/Turkjsurg.2018.011018 13Th Turkish Congress of Hepato-Pancreato-Biliary Surgery

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ORAL PRESENTATIONS Turk J Surg 2017; 33 (Suppl.-1): 1-92 DOI: 10.5152/Turkjsurg.2018.011018 13Th Turkish Congress of Hepato-Pancreato-Biliary Surgery 13th TURKISH CONGRESS OF HEPATO-PANCREATO-BILIARY SURGERY 1-4 NOVEMBER 2017 / Antalya www.hpb2017.org ORAL PRESENTATIONS Turk J Surg 2017; 33 (Suppl.-1): 1-92 DOI: 10.5152/turkjsurg.2018.011018 13th Turkish Congress of Hepato-Pancreato-Biliary Surgery SS-01 Patients with malignant liver tumors who consulted after the diagnosis of hemangioma İbrahim Tayfun Şahiner1, Arzu Poyanlı1, Bülent Acunaş2, Mine Güllüoğlu3, Cem İbiş4, Yaman Tekant4, İlgin Özden4 1Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey; Department of General Surgery, Medical Faculty, Hitit University, Çorum, Turkey 2Department of Radiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey 3Department of Pathology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey 4Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey Introduction: Taking lessons from the experiences gained from patients who had been followed up due to the diagnosis of hemangioma in other health institutions but were found to have malignant tumors in our institution. Method: The recordings of 15 patients treated between January 2003 and May 2016 were examined retrospectively. Results: The median age of patients, 8 of whom were male, was 56 years (35-80 years). Ultrasonography (n:6), MR (n:6), and CT (n:3) had been used for the final diagnosis in another center. In our department, 13 of patients had MR and 2 of them were diagnosed with malignant tumor based on CT taken in the other center. In other words, ultrasonography findings of the other center were not confirmed by MR examination performed in our department and it was seen that CT and MR images of other patients were inadequate and/or misinterpreted. Ten of patients were carried out surgical intervention and 3 and 2 patients who had no chance for resection were administered chemotherapy and chemoembolization, respectively. One of patients was not performed indication of surgical resection because of the presence of metastatic liver tumor of unknown primary. Diagnostic error caused approximately 6- month treatment retardation in median (minimum 0-maximum 96). The final diagnoses were hepatocellular carcinoma in 11 patients, sarcomatoid hepatocellular carcinoma in one each patient, poorly differentiated adeno- carcinoma, angiosarcoma, and metastatic liver tumor of unknown- primary. Conclusion: Performance of high-quality MR or CT imaging and accurate interpretation of findings have the vital importance in the diagnosis of liver lesions. Performing control imaging after 4-6 months despite typical radiological findings will decrease margin of error. Keywords: Hemangioma, liver, malignant tumor SS-02 5-year survival rates of extended hepatobiliary resection for perihilar cholangiocarcinoma: Experience of Istanbul Medical Faculty İlgin Özden1, Orhan Bilge1, Nergiz Dağoğlu2, Ayşen Yavru3, Mine Güllüoğlu4, Arzu Poyanli5, Yaman Tekant1, Ahmet Kızir2 1Department of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey 2Department of Radiation Oncology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey 3Department of Anesthesiology and Reanimation, İstanbul University İstanbul School of Medicine, İstanbul, Turkey 4Department of Pathology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey 5Department of Radiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey Introduction: To examine the results of patients who were operated for perihilar cholangiocarcinoma between 2001 and 2012 and followed up for at least 5 years. Method: The recordings of 53 patients operated for perihilar cholangiocarcinoma in study period were examined. After the computed tomography and/or magnetic resonance imaging for all patients, preparation for extended hepatobiliary resection was made. The postoperative risk of liver failure was decreased by using the methods of percutaneous biliary S2 drainage, calculation of hepatectomy level, portal vein branch embolization, drinking bile, evaluation of bile quality, and Turk J Surg 2017; 33 (Suppl.-1): 1-92 indocyanine green clearance test when needed. Adjuvant radiotherapy has been used since 2007 and adjuvant chemo- therapy since 2011. Results: Of the patients, 27 were male and 26 were female. The median age was 54 years (29-74 years). Before the surgery, 41 patients (77%) underwent percutaneous biliary drainage and 8 patients (15%) underwent portal vein branch embolization. Right hepatectomy in 27 patients (51%), left hepatectomy in 25 patients (47%), and right trisectionectomy in 1 patient were performed with caudate lobectomy (total or subtotal) and extrahepatic biliary tract resection. Portal vein resection was required to be performed in 10 patients (19%). 90-day mortality was 4% (2/53). A total of 16 patients was administered adjuvant radio- therapy and 4 patients were additionally administered adjuvant chemotherapy. Except one patient, all of them were followed up. Including deaths in hospital, the median survival was detected to be 48 months and 5-year survival rate was 41%. Five pa- tients lived longer than 10 years; 3 are alive with non-recurrence and one with recurrence. Conclusion: If major hepatobiliary resection is performed with low mortality in patients with perihilar cholangiocarcinoma, suc- cessful survival rates are obtained. For revealing the contributions of adjuvant radiotherapy and chemotherapy precisely, more data are needed. Keywords: Hepatobiliary resection, cholangiocarcinoma, perihilar cholangiocarcinoma SS-03 Surgical approach to gallbladder tumors: 5-year experience Muharrem Battal1, Mehmet Kostek1, Pınar Yazıcı1, Özgür Bostancı1, Oğuzhan Karatepe2 1Department of General Surgery, Şişli Etfal Hamidiye Training and Research Hospital, İstanbul, Turkey 2Department of General Surgery, Private Memorial Hospital, İstanbul, Turkey Introduction: The incidence of quiet rarely seen gall bladder cancers is 1.6/100 000 in Turkey. They are incidentally detected in cholecystectomy procedures which are performed at the rates of 60-70%. Unfortunately, very few patients with gallbladder can- cer access to only curative treatment choice of surgery. In this study, we aimed to evaluate our surgical approach and outcomes in patients with gallbladder cancer who were treated in our department. Method: Twenty-one patients who were operated for gallbladder tumors or incidentally found to have gallbladder cancer in the last 5 year-period (May 2012-May 2017) were included in this study. Demographic features, preoperative imaging and laboratory results, surgical data, and postoperative follow-up results (morbidity and mortality) of these patients were examined. Results: Our patient series involved 12 female and 9 male patients, whose mean age was 66±10 years. While suspected find- ings for gallbaldder ca were detected in preoperative examinations of 14 patients (67%), it was incidentally found in 7 patients (33%). When preoperative laboratory values were evaluated, CEA test scores were found be positive in 7 of 14 patients, Ca 19-9 test scores were positive in 7 of 14 patients and AFP test scores were found to be positive in 1 of 10 patients. Six of cases were considered as inoperable according to the results of preoperative radiological examinations (4 cases) or peroperatively (2 cases). Fifteen patients were performed cholecystectomy, pericholedochal/hepatoduodenal lymph node dissection and resection of liver segment 4B and 5; additional choledochal resection-hepaticojejunostomy was performed to 5 patients (33%); and due to direct invasion, additional colon resection was performed in 2 patients (13%). The pathological staging of the patients was stated as T1a (n=1), T1b+T2 (n=3), and >=T3a (n=17). The invasion rate of lymph node was 76%. Conclusion: Gall bladder cancer is generally determined at advanced stages in elderly patients. The curative treatment for gall bladder cancer is still surgery. In the surgery, performing R0 resection and lymph node dissection in case of muscular layer in- volvement to patients, provide the advantage of survival. Keywords: Gall bladder, cancer, surgery, biliary tract SS-04 Liver resections with the ablation application in colorectal liver metastases Metin Tilki1, Mehmet Ali Uzun1, Anıl Koçman1, Zeynep Gamze Kılıçoğlu2, Ali Sürmelioğlu1, Selvinaz Özkara3, Ender Dulundu1 1Department of General Surgery, Haydarpaşa Numune Training and Research Hospital, Health Sciences University, İstanbul, Turkey 2Department of Radiology, Haydarpaşa Numune Training and Research Hospital, Health Sciences University, İstanbul, Turkey S3 13th Turkish Congress of Hepato-Pancreato-Biliary Surgery 3Laboratory of Pathology, Haydarpaşa Numune Training and Research Hospital, Health Sciences University, İstanbul, Turkey Introduction: Liver resection is a treatment technique with curative potential for liver metastases of colorectal tumors. Ap- proximately 10-15% of these patients are suitable for liver resection. Ablation-assisted liver resection is one of methods used for making inoperable patient operable for resection in liver metastases of colorectal tumors. Oncological results of this method are controversial because of the lack of comparative prospective studies. The aim of this study is to evaluate survival rates of patients undergoing only liver resection due to colorectal metastasis or resection with ablation. Method: Prospective data of patients that were operated in Haydarpaşa Numune Hospital due to colorectal
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