Person: TAŞAR, PINAR
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TAŞAR
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PINAR
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Publication Early results of conservative and surgical approach in endoscopic retrograde cholangiopancreatography (ERCP) perforations single center experience(Edizioni Luigi Pozzi, 2023-07-01) Taşar, Pınar; Kılıçturgay, Sadık Ayhan; TAŞAR, PINAR; KILIÇTURGAY, SADIK AYHAN; Tıp Fakültesi; Genel Cerrahi Bölümü; IIC-9825-2023; IDN-9824-2023Early results of conservative and surgical approach in Endoscopic Retrograde Cholangiopancreatography INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) +/- endoscopic sphincterotomy, and after perforation (ERCP-P), which is a common method used for the diagnosis in the past and treatment today in hepatopancreatobiliary cases, is a rare complication with high mortality. While surgery has been at the forefront in perforations after ERCP in previous years, conservative treatment is widely accepted today, except for some special conditions. The aim of this study was to determine the incidence of ERCP-P in a hepatobiliary center, the outcome of the treatment modalities applied, and the risk factors for mortality due to perforations. MATERIALS AND METHODS: Patients hospitalized in our clinic with the diagnosis of ERCP-P were retrospectively analyzed. Age, gender, ERCP indication, method of treatment applied, time between ERCP-P diagnosis and treatment, injury class, length of stay (LOS) and early results of the patients were examined. RESULTS: 45 patients were hospitalized in our clinic upon the development of ERCP-P between the years of 2006 and 2022. 37 of these patients underwent conservative and 8 patients underwent surgical treatment. When the perforation types were examined, Stapfer Type 1 was found in 4 patients, Type II in 6 patients, Type III in 3 patients and Type IV ERCP-P in 32 patients (71.1%). LOS was longer in the surgical group than in the conservative treatment group (p=0.040). Mortality was observed in 15.56% of patients. 57.1% of these patients were in the surgical group. In the multivariate analysis, the time between diagnosis and treatment of ERCP-P, which is the only factor affecting mortality, was found. The risk of death was found to be 30.61 times higher in patients with a time elapsed between ERCP-P diagnosis and treatment exceeding 24 hours compared to patients with a time elapsed <= 24 hours (p=0.030). DISCUSSION: In our study, it was observed that the prognosis of the patients in the surgical group was poor and the length of stay was significantly longer. At the same time, the only effective factor on mortality is the time between ERCPP diagnosis and treatment.Publication Solid pseudopapillary neoplasms of the pancreas: Is there a factor determining the prognosis? Experience of a single institution(Lippincott Williams & Wilkins, 2022-08-26) KILIÇTURGAY, SADIK AYHAN; Kılıçturgay, Sadık Ayhan; Taşar, Pınar; TAŞAR, PINAR; Tıp Fakültesi; Genel Cerrahi Ana Bilim DalıSolid pseudopapillary neoplasms (SPNs) are frequently seen in young women. Although the behavior pattern varies, these rare lesions generally have a low malignant potential. In this study, the aim was to investigate the effect of clinicopathological features of lesions on the recurrence in and survival of patients. In this study, patients of our clinic who were pathologically diagnosed with SPN after pancreatic surgery between July 2008 and December 2020 were evaluated retrospectively. Patients' age, gender, comorbidities, symptoms at the time of application, preoperative CA 19-9, CEA value, preoperative cross-sectional diagnostic imaging method and lesion characteristics, surgery, postoperative complications, length of hospital stay, and histopathological features were evaluated. Early and late mortality, overall survival, disease-free survival, and recurrence rate were determined. Four of the 23 patients diagnosed with SPN were male and the median age was 29 (23-47) years. Of the study patients, 69.56% experienced pain symptoms and 30.43% were asymptomatic. The median tumor size was 4 cm (1.5-15). The most common surgical procedure was distal pancreatectomy (56.5%). The median length of hospital stays was 5 (3-120) days and morbidity was observed in 9 cases (39.13%). The mortality rate was 4.35%. The mean follow-up period in the series was 53 (8-132) months and none of the patients developed recurrence. In this study, no significant difference was found regarding recurrence in patients with SPN with histopathologically aggressive biological behavior. The overall survival rate was 95.7%. SPNs are rare lesions with low malignant potential. SPNs are associated with longer-term survival after surgical resection.Publication Comparison of severity and complication rates of acute cholecystitis during pandemic and pre-pandemic periods?(Sage Publications Ltd, 2022-11-22) Candan, Selman; Dündar, Halit Ziya; Öngen, Gökhan; AKSOY, FUAT; Özpar, Rıfat; ERDEMLİ GÜRSEL, BAŞAK; ÖZPAR, RİFAT; NAS, ÖMER FATİH; İNECİKLİ, MEHMET FATİH; Gürsel, Başak Erdemli; TAŞAR, PINAR; Savcı, Gürsel; SAVCI, GÜRSEL; Nas, Ömer Fatih; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; AAG-8561-2021; AAH-6568-2021; AAK-5124-2020Background Cancellations of surgeries for elective cases and late admissions of symptomatic cases during the pandemic period might have increased the number of cases of acute cholecystitis and its complications. Purpose To compare the severity of acute cholecystitis and complication rates during the pandemic and pre-pandemic periods. Material and Methods We evaluated the computed tomography (CT) findings observed for the diagnosis of complications for both acute simple and acute complicated cholecystitis during both the pandemic and pre-pandemic periods. Patients admitted to the hospital between March 2020 and December 2020 made up the study group and the corresponding appropriate patients from one year earlier were studied as the control group. In addition to the CT findings, clinical and laboratory findings, co-morbidities such as diabetes, as well as the admission time to hospital from the onset of the initial symptoms to hospital admission were also evaluated. Results A total of 88 patients were evaluated (54 in the study group, 34 in the control group; mean age = 64.3 +/- 16.3 years). The male-to-female ratio was 51/37. The number of patients diagnosed with complicated cholecystitis were significantly higher in the study group (P = 0.03). Murphy finding and diabetes status were similar between the two groups (P = 0.086 and P = 0.308, respectively). Admission time to the hospital was significantly different for study and control groups in simple cholecystitis patients (P = 0.045); with no significant difference in cases of complicated cholecystitis (P = 0.499). Conclusion Our study reveals the course of acute cholecystitis during the pandemic period was much more serious with higher complications.Publication Recurrent hepatocellular carcinoma after liver transplantation: Identifying the high-risk patient using the expression profiles of emt-associated lncrnas(Frontiers Media Sa, 2019-10-01) Aksoy, Seçil Ak; Aksoy, Fuat; Dündar, Haliz Ziya; Tunca, Berrin; Taşar, Pınar; Uğraş, Nesrin; Egeli, Ünal; Çeçener, Gülşah; Yerci, Ömer; Kaya, Ekrem; Aksoy, Seçil Ak; AKSOY, FUAT; Dündar, Haliz Ziya; TUNCA, BERRİN; TAŞAR, PINAR; UĞRAŞ, NESRİN; EGELİ, ÜNAL; ÇEÇENER, GÜLŞAH; YERCİ, ÖMER; KAYA, EKREM; Tıp Fakültesi; 0000-0001-5808-9384; 0000-0002-1619-6680; 0000-0001-7904-883X; 0000-0002-3820-424X; AAH-8540-2021; AAG-7319-2021; AAP-9988-2020; ABI-6078-2020; AAH-1420-2021; AAH-2716-2021; HII-8895-2022; EGD-8703-2022; IIC-9825-2023Publication Turkish HPB surgery association consensus report on hepatic cystic echinococcosis (HCE)(Türk Cerrahi, 2022-06-01) Özturk, Gürkan; Uzun, Mehmet Ali; Özkan, Ömer Faruk; Kayaalp, Cüneyt; Tatlı, Faik; Eren, Suat; Aksungur, Nurhak; Çökert, Ahmet; Bostanci, Erdal Birol; Oter, Volkan; Kaya, Ekrem; Taşar, Pınar; KAYA, EKREM; TAŞAR, PINAR; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; 0000-0002-2378-0666; 0000-0002-9562-4195; AAG-7319-2021; IIC-9825-2023Objective: Cystic Echinococcosis (CE) is one of the important problems of the Eurasian region. We aimed to prepare a consensus report in order to update the treatment approaches of this disease. This study was conducted by Turkish HPB Surgery Association.Material and Methods: This study was conducted with the modified Delphi model. For this purpose, we conducted a three-stage consensus-building approach.Results: Six topics, including diagnosis, medical treatment, percutaneous treatment, surgical treatment, management of complications and posttreatment follow-up and recurrences in HCE were discussed.Conclusion: The expert panel made recommendations for every topic.Publication Report of a case mimicking the acute appendicitis; small bowel perforation due to olive leaf(Turkish Assoc Trauma Emergency Surgery, 2023-05-01) Tırnova, İsmail; Balçın, Özkan; Taşar, Pınar; TAŞAR, PINAR; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; 0000-0003-4488-1607; AHB-4845-2022Abdominal pain is one of the most frequent causes of emergency room admissions. Acute appendicitis is the most common surgical pathology in these patients. Foreign body ingestion is a quite rare pathology that takes place in list of differential diagnosis of acute appendicitis. We presented a dry olive leaf ingestion case in this paper.Publication Portal vein injury following endoscopic retrograde cholangiopancreatography: A case report(Turkish Assoc Trauma Emergency Surgery, 2023-03-01) Taşar, Pınar; TAŞAR, PINAR; Kılıçturgay, Sadık Ayhan; KILIÇTURGAY, SADIK AYHAN; Tıp Fakültesi; Genel Cerrahi Ana Bilim DalıEndoscopic retrograde cholangiopancreatography (ERCP) has been a widely used procedure in the diagnosis and treatment of various pancreaticobiliary disorders. Although widely considered a safe procedure, ERCP is associated morbidity and occasional mortality. The most common complications include acute pancreatitis, hemorrhage, and duodenal perforation. Portal vein cannulation is a rare complication of ERCP. We described a case of placement of an endoscopic biliary stent in the portal vein during ERCP and sphinc-terotomy. A 54-year-old female patient underwent laparoscopic cholecystectomy with a pre-diagnosis of chronic cholecystitis with gallstones. She visited emergency unit with the complaint of jaundice and itching on the 4th post-operative day. On the magnetic res-onance cholangiopancreatography, the intrahepatic and the extrahepatic bile ducts were dilated and a 7.5x5.5 mm stone at common bile duct. Sphincterotomy was performed by ERCP, the stones were removed, and then a 10F 7 cm stent was installed. Abdominopelvic computed tomography (CT) was performed on the 4th day of ERCP in the patient whose fever and total bilirubin levels persisted at 5 mg/dL, considering cholangitic abscess and/or ERCP complication. On the CT, the proximal end of the stent in the common bile duct was observed to enter into the main portal vein and the tip was observed to be thrombosed. Therefore, it was decided to remove the stent endoscopically under operating room conditions. After the anesthesia induction, the stent was endoscopically removed by the gastroenterology team. The abdominal cavity of patient was explored laparoscopically in the during of stent removal. The patient did not experience hemodynamic instability and did not require transfusion during anesthesia but had melena once on the clinical follow-up. The patient was discharged with low molecular weight heparin and oral cephalosporin and was advised to return for polyclinic control. Doppler ultrasonography (USG) was performed to evaluate the thrombosis of the portal vein in the patient who had intermittent fever during the controls. Doppler USG revealed a thrombosed appearance in the main portal vein and its branches. The patient, who was in good general condition and had no abdominal pain, was switched to high-dose low molecular weight heparin and followed under the control of the gastroenterology and general surgery outpatient clinic. This rare life-threatening complication should always be kept in mind especially during the procedure and/or in the clinical follow-up of the patient.Publication Early results of conservative and surgical approach in endoscopic retrograde cholangiopancreatography (ERCP) perforations single center experience(Edizioni Luigi Pozzi, 2023-07-01) Taşar, Pınar; Kılıçturgay, Sadık Ayhan; TAŞAR, PINAR; KILIÇTURGAY, SADIK AYHAN; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; IIC-9825-2023; IDN-9824-2023INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) +/- endoscopic sphincterotomy, and after perforation (ERCP-P), which is a common method used for the diagnosis in the past and treatment today in hepatopancreatobiliary cases, is a rare complication with high mortality. While surgery has been at the forefront in perforations after ERCP in previous years, conservative treatment is widely accepted today, except for some special conditions. The aim of this study was to determine the incidence of ERCP-P in a hepatobiliary center, the outcome of the treatment modalities applied, and the risk factors for mortality due to perforations.MATERIALS AND METHODS: Patients hospitalized in our clinic with the diagnosis of ERCP-P were retrospectively analyzed. Age, gender, ERCP indication, method of treatment applied, time between ERCP-P diagnosis and treatment, injury class, length of stay (LOS) and early results of the patients were examined.RESULTS: 45 patients were hospitalized in our clinic upon the development of ERCP-P between the years of 2006 and 2022. 37 of these patients underwent conservative and 8 patients underwent surgical treatment. When the perforation types were examined, Stapfer Type 1 was found in 4 patients, Type II in 6 patients, Type III in 3 patients and Type IV ERCP-P in 32 patients (71.1%). LOS was longer in the surgical group than in the conservative treatment group (p=0.040). Mortality was observed in 15.56% of patients. 57.1% of these patients were in the surgical group. In the multivariate analysis, the time between diagnosis and treatment of ERCP-P, which is the only factor affecting mortality, was found. The risk of death was found to be 30.61 times higher in patients with a time elapsed between ERCP-P diagnosis and treatment exceeding 24 hours compared to patients with a time elapsed <= 24 hours (p=0.030).DISCUSSION: In our study, it was observed that the prognosis of the patients in the surgical group was poor and the length of stay was significantly longer. At the same time, the only effective factor on mortality is the time between ERCPP diagnosis and treatment.Publication What has changed in the last 20 years in the postoperative specimen findings of the papillary thyroid cancer cases? A retrospective analysis(Turkish Surgical Assoc, 2022-12-01) Bakar, Burak; Taşar, Pınar; Kırdak, Türkay; Kılıçturgay, Sadık; BAKAR, BURAK; TAŞAR, PINAR; Kırdak, Türkay; KILIÇTURGAY, SADIK AYHANObjective: In this study, it was aimed to investigate the changes in surgical approaches and histopathological evaluation of the tumor according to years of patients who were operated on with the diagnosis of thyroid papillary cancer (PTC) in our center in the last 20 years.Material and Methods: The records of the cases who underwent thyroidectomy in our department were divided into four groups of five years each and analyzed retrospectively. Demographic characteristics, surgical procedures, presence of chronic lymphocytic thyroiditis, histopathological features of tumour and hospital stay of the cases in the groups were evaluated. Based on tumor size, PTCs were classified into five subgroups. PTCs of 10 (mm) or less were accepted as papillary thyroid microcarcinoma (PTMC).Results: There was a significant increase in PTC and multifocal tumors in the groups over the years (p<0.001). There was a significant increase between the groups in the presence of chronic lymphocytic thyroiditis (p<0.001). In contrast, the total number of metastatic lymph nodes (p=0.486) and the largest metastatic lymph node size were similar between the groups (p> 0.999). In our study, it was observed that there was a significant increase over the years in both the total/near-total thyroidectomy cases and the number of cases with a postoperative hospital stay of one day (p<0.001).Conclusion: In the present study, it was found that papillary cancer sizes decreased gradually and the frequency of papillary microcarcinoma increased gradually in last 20 years. Also, a significant increase was detected in the rates of total/near-total thyroidectomy and lateral neck dissection over the years.Publication The expression status of cancer stem cell markers may predict poor prognosis in patients undergoing liver transplantation for hepatocellular carcinoma(Frontiers Media Sa, 2019-10-01) Aksoy, Fuat; Dündar, Haliz Ziya; Aksoy, Seçil Ak; Tunca, Berrin; Taşar, Pınar; Uğraş, Nesrin; Egeli, Ünal; Çeçener, Gülşah; Yerci, Ömer; AKSOY, FUAT; Dündar, Haliz Ziya; Aksoy, Seçil Ak; TUNCA, BERRİN; TAŞAR, PINAR; UĞRAŞ, NESRİN; EGELİ, ÜNAL; ÇEÇENER, GÜLŞAH; YERCİ, ÖMER; Tıp Fakültesi; 0000-0001-5808-9384; 0000-0002-1619-6680; 0000-0001-7904-883X; 0000-0002-3820-424X; AAH-8540-2021; ABI-6078-2020; HII-8895-2022; AAH-2716-2021; AAP-9988-2020; AAH-1420-2021; COU-1400-2022; IIC-9825-2023; EGD-8703-2022