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  1. Article ; Online: An underestimated "false negative COVID cholecystitis" in Northern Italy and the contagion of a surgical ward: it can happen everywhere.

    Giulio, Mari / Achilli, Pietro / Dario, Maggioni

    Updates in surgery

    2020  Volume 72, Issue 2, Page(s) 315–316

    MeSH term(s) Acute Disease ; COVID-19 ; COVID-19 Testing ; Cholecystectomy, Laparoscopic ; Cholecystitis/complications ; Cholecystitis/drug therapy ; Cholecystitis/surgery ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Coronavirus Infections/etiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; False Negative Reactions ; Female ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Italy ; Middle Aged ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/etiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission
    Keywords covid19
    Language English
    Publishing date 2020-05-13
    Publishing country Italy
    Document type Case Reports ; Letter
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-020-00781-y
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  2. Article ; Online: The Dilemma of the Level of the Inferior Mesenteric Artery Ligation in the Treatment of Diverticular Disease

    Roberto Cirocchi / Giulio Mari / Bruno Amato / Giovanni Domenico Tebala / Georgi Popivanov / Stefano Avenia / Riccardo Nascimbeni

    Journal of Clinical Medicine, Vol 11, Iss 917, p

    A Systematic Review of the Literature

    2022  Volume 917

    Abstract: Background and aim: Although sigmoidectomy is a well-standardized procedure for diverticular disease, there are still unclear areas related to the varying morphology and vascular supply of the sigmoid colon. The level of vascular ligation could affect ... ...

    Abstract Background and aim: Although sigmoidectomy is a well-standardized procedure for diverticular disease, there are still unclear areas related to the varying morphology and vascular supply of the sigmoid colon. The level of vascular ligation could affect the functional outcomes of patients operated on for diverticular disease. The aim of this review is to primarily evaluate sexual, urinary and defecatory function outcomes, as well as postoperative results, in patients who underwent surgery for diverticular disease, with or without inferior mesenteric artery (IMA) preservation. Materials and methods: The MEDLINE/PubMed, WOS and Scopus databases were interrogated. Comparative studies including patients who underwent sigmoidectomy for diverticular diseases were considered. Bowel function, genitourinary function, anastomotic leak, operation time, conversion to open surgery, anastomotic bleeding, bowel obstruction were the main items of interest. Results: Twelve studies were included in the review, three randomized and nine comparative studies. Bowel and genitourinary function are not differently affected by the level of vascular ligation. The site of ligation of IMA did not influence the rate of functional complications, anastomotic leak and bleeding. Of note, the preservation of IMA is associated with a higher conversion rate and longer operative time. Conclusions: Despite the heterogeneity of patient groups, and although the findings should be interpreted with caution, functional and clinical outcomes after sigmoidectomy for diverticular disease do not seem to be affected by the level of vascular ligation as long as the IMA is ligated far from its origin.
    Keywords diverticular disease ; vascular ligation ; IMA ; outcomes ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: An underestimated "false negative COVID cholecystitis" in Northern Italy and the contagion of a surgical ward: it can happen everywhere

    Giulio, Mari / Achilli, Pietro / Dario, Maggioni

    Updates Surg

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #260026
    Database COVID19

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  4. Article ; Online: Recurrent diverticulitis after elective surgery.

    Giulio, Mari / Gaia, Santambrogio / Andrea, Costanzi / Giacomo, Calini / Angela, La Porta / Dario, Maggioni / Isacco, Montroni

    International journal of colorectal disease

    2022  Volume 37, Issue 10, Page(s) 2149–2155

    Abstract: Purpose: Elective sigmoid resection is proposed as a treatment for symptomatic diverticular disease for the possible improvement in quality of life achievable. Albeit encouraging results have been reported, recurrent diverticulitis is still a concern ... ...

    Abstract Purpose: Elective sigmoid resection is proposed as a treatment for symptomatic diverticular disease for the possible improvement in quality of life achievable. Albeit encouraging results have been reported, recurrent diverticulitis is still a concern deeply affecting quality of life. The aim of this study is to determine the rate of recurrent diverticulitis after elective sigmoid resection and to look for possible perioperative risk factors.
    Methods: Patients who underwent elective resection for DD with at least a 3-year follow-up were included. Postoperative recurrence was defined as left-sided or lower abdominal pain, with CT scan-confirmed findings of diverticulitis.
    Results: Twenty of 232 (8.6%) patients developed CT-proven recurrent diverticulitis after elective surgery. All the 20 recurrent diverticulitis were uncomplicated and did not need surgery. Eighty-five percent of the recurrences occurred in patients with a preoperative diagnosis of uncomplicated DD, 70% in patients who had at least 4 episodes of diverticulitis, and 70% in patients with a history of diverticulitis extended to the descending colon. Univariate analysis showed that recurrence was associated with diverticulitis of the sigmoid and of the descending colon (p = 0.04), with a preoperative diagnosis of IBS (p = 0.04) and with a longer than 5 years diverticular disease (p = 0.03). Multivariate analysis was not able to determine risks factors for recurrence.
    Conclusion: Our study showed that patients with a preoperative diagnosis of IBS, diverticulitis involving the descending colon, and a long-lasting disease are more likely to have recurrent diverticulitis. However, these variables could not be assumed as risk factors.
    MeSH term(s) Colon, Sigmoid/diagnostic imaging ; Colon, Sigmoid/surgery ; Diverticular Diseases/surgery ; Diverticulitis/complications ; Diverticulitis/diagnostic imaging ; Diverticulitis/surgery ; Diverticulitis, Colonic/complications ; Diverticulitis, Colonic/diagnostic imaging ; Diverticulitis, Colonic/surgery ; Elective Surgical Procedures/adverse effects ; Humans ; Irritable Bowel Syndrome/complications ; Quality of Life ; Recurrence
    Language English
    Publishing date 2022-09-01
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-022-04248-x
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    Zs.A 2121: Show issues Location:
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  5. Article ; Online: Case Report

    Angelo Miranda / Andrea Rosato / Andrea Costanzi / Lucia Pisano / Sara Colzani / Sara Auricchio / Giulio Mari / Pietro Achilli / Dario Maggioni

    F1000Research, Vol

    Acute kidney failure leading to permanent haemodialysis due to hyperoxaluria following one-anastomosis gastric bypass-related rapid weight loss. [version 2; peer review: 2 approved]

    2020  Volume 9

    Abstract: The one-anastomosis gastric bypass (OAGB) has been proven to provide good weight loss, comorbidity improvement, and quality of life with follow-up longer than five years. Although capable of improving many obesity-related diseases, OAGB is associated ... ...

    Abstract The one-anastomosis gastric bypass (OAGB) has been proven to provide good weight loss, comorbidity improvement, and quality of life with follow-up longer than five years. Although capable of improving many obesity-related diseases, OAGB is associated with post-operative medical complications mainly related to the induced malabsorption. A 52-year-old man affected by nephrotic syndrome due to a focal segmental glomerulosclerosis underwent OAGB uneventfully. At three months post-surgery, the patient had lost 40kg, reaching a BMI of 32. The patient was admitted to the nephrology unit for acute kidney injury with only mild improvement in renal function (SCr 9 mg/dl); proteinuria was still elevated (4g/24h), with microhaematuria. A renal biopsy was performed: oxalate deposits were demonstrated inside tubules, associated with acute and chronic tubular and interstitial damage and glomerulosclerosis (21/33 glomeruli). Urinary oxalate levels were found to be elevated (72mg/24h, range 13-40), providing the diagnosis of acute kidney injury due to hyperoxaluria, potentially associated to OAGB. No recovery in renal function was observed and the patient remained dialysis dependent. Early and rapid excessive weight loss in patients affected by chronic kidney insufficiency could be associated with the worsening of renal function. Increased calcium oxalate levels associated with OAGB-related malabsorption could be a key factor in kidney injury.
    Keywords Medicine ; R ; Science ; Q
    Subject code 616
    Language English
    Publishing date 2020-05-01T00:00:00Z
    Publisher F1000 Research Ltd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Being a Doctor Will Never Be the Same After the COVID-19 Pandemic.

    Giulio, Mari / Maggioni, Dario / Montroni, Isacco / Ugolini, Giampaolo / Capelli, Patrizio / Ceppi, Lorenzo / Bonfanti, Paolo / Mariani, Andrea / Achilli, Felice

    The American journal of medicine

    2020  Volume 133, Issue 6, Page(s) 652

    MeSH term(s) Betacoronavirus/isolation & purification ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Humans ; Italy/epidemiology ; Pandemics ; Patient Care Management/trends ; Physician's Role ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-03-30
    Publishing country United States
    Document type Editorial
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2020.03.003
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  7. Article: Being a Doctor Will Never Be the Same After the COVID-19 Pandemic

    Giulio, Mari / Maggioni, Dario / Montroni, Isacco / Ugolini, Giampaolo / Capelli, Patrizio / Ceppi, Lorenzo / Bonfanti, Paolo / Mariani, Andrea / Achilli, Felice

    Am J Med

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #19660
    Database COVID19

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  8. Article ; Online: Being a Doctor Will Never Be the Same After the COVID-19 Pandemic

    Giulio, Mari / Maggioni, Dario / Montroni, Isacco / Ugolini, Giampaolo / Capelli, Patrizio / Ceppi, Lorenzo / Bonfanti, Paolo / Mariani, Andrea / Achilli, Felice

    The American Journal of Medicine

    2020  Volume 133, Issue 6, Page(s) 652

    Keywords General Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2020.03.003
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Ua VI Zs.289: Show issues Location:
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  9. Article ; Online: Small Bowel Perforation Caused by Pancreaticojejunal Anastomotic Stent Migration after Pancreaticoduodenectomy for Periampullary Carcinoma

    Giulio Mari / Andrea Costanzi / Nicola Monzio / Angelo Miranda / Michele Rossi / Luca Rigamonti / Jacopo Crippa / Paola Sartori / Dario Maggioni

    JOP Journal of the Pancreas, Vol 16, Iss 2, Pp 185-

    2015  Volume 188

    Abstract: Context Pancreaticoduodenectomy is the gold standard for patients with resectable periampullary carcinoma. The protection of the anastomosis by positioning of an intraluminal stent is a technique used to lower the frequency of anastomotic fistulas. ... ...

    Abstract Context Pancreaticoduodenectomy is the gold standard for patients with resectable periampullary carcinoma. The protection of the anastomosis by positioning of an intraluminal stent is a technique used to lower the frequency of anastomotic fistulas. However the use of anastomotic stents is still debated and stent related complications are reported. Case report A fifty-three-year old male underwent pancreaticoduodenectomy (PD) for a T2N0 periampullary carcinoma with a pancreaticojejunal (duct to mucosa) anastomosis protected by a free floating 6 Fr Nelaton stent in the Wirsung duct. Twenty-three months after surgery the patient accessed Emergency Department for severe abdominal pain associated to temperature, high white blood cell count and an significant increase in C reactive protein. Method Abdominal CT scan shown the presence of a tubular stent in the mesogastrium/lower right quadrant. No evident free intra-abdominal air was detected. The patient was submitted to explorative laparotomy. After debridement for localized peritonitis the Nelaton trans anastomotic stent was found in the abdomen. There was no evidence of bowel perforation, but intestinal loops covered with fibrin and suspect for impending perforation were resected. Conclusion There is a lack of evidence about the true rate of post-operative complications related to pancreatic stenting. We believe that in patients presenting with abdominal pain or peritonitis that previously underwent PD with stentguided pancreaticojejunal anastomosis, the hypothesis of stent migration should at least be taken into consideration.
    Keywords Pancreatic stunting ; anastomosis ; Diseases of the digestive system. Gastroenterology ; RC799-869 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2015-05-01T00:00:00Z
    Publisher E S Burioni Ricerche Bibliografiche
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Pancreaticojejunal Anastomotic Stent-Related Complications afterPancreaticoduodenectomy. Review of the Literature

    Giulio Mari / Andrea Costanzi / Andrea Rosato / Jacopo Crippa / Alessandra De Scalzi / Elisa Galfrascoli / Michele Rossi / Angelo Miranda / Valter Berardi / Paola Sartori / Dario Maggioni

    JOP Journal of the Pancreas, Vol 16, Iss 5, Pp 413-

    2015  Volume 416

    Abstract: The placement of a stent in the Wirsung across the anastomosis is widely accepted to perform pancreaticojejunostomy during pancreaticoduodenectomy. Beyond being related to pancreaticojejunal anastomosis failure, stent placement can lead to other ... ...

    Abstract The placement of a stent in the Wirsung across the anastomosis is widely accepted to perform pancreaticojejunostomy during pancreaticoduodenectomy. Beyond being related to pancreaticojejunal anastomosis failure, stent placement can lead to other complications. Stent migration, stenosis of the pancreatic duct, obstruction, stent occlusion, intestinal obstruction, or fracture of the stent are reported as late complications after pancreaticoduodenectomy. Internal stents are supposed to pass spontaneously into and out of the bowel at a variable postoperative interval. However stent persistence in the gastrointestinal tract can be associated with subsequent complications. Their management is reported to be endoscopical when possible but also surgical when bowel perforation occurs. Despite the rarity of these complications, surgeons should be aware of their potential role in unclear post-operative abdominal pain when deciding whether to place a stent when performing a pancreaticojejunostomy.
    Keywords Pancreaticojejunostomy ; Pancreaticoduodenectomy; Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Diseases of the digestive system. Gastroenterology ; RC799-869
    Publishing date 2015-09-01T00:00:00Z
    Publisher E S Burioni Ricerche Bibliografiche
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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