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  1. Article ; Online: The HELLP syndrome: clinical issues and surgical management. A Case Experience.

    De Luca, Giuseppe Massimiliano / Danese, Viviana / Franzoso, Lucia / De Luca, Alessandro / De Luca, Francesco Luca / Tromba, Antonella / Farinelli, Miriam / Barbieri, Paolo / Perrone, Alessandro / Landolfo, Giovanni

    Annali italiani di chirurgia

    2023  Volume 12

    Abstract: Aim: This study aims to challenge the current know-how in patients with spontaneous rupture of a liver hematoma, to differentiate amongst patients requiring such specific surgical therapy and avoiding mistakes during surgical operations, in order to ... ...

    Abstract Aim: This study aims to challenge the current know-how in patients with spontaneous rupture of a liver hematoma, to differentiate amongst patients requiring such specific surgical therapy and avoiding mistakes during surgical operations, in order to terminate pregnancy with beneficial effects on the mother and fetus.
    Materials and methods: In a emergency scenario we admitted a 37-year-old woman at 35+4 weeks of gestation for emergency cesarean section after the onset of right hypochondrium pain. A diagnosis of hemoperitoneum and severe preeclampsia with liver and splenic bleeding was done and managed with packing of hepatic and splenic hematomas and according to her haemo-dynamic clinical conditions, done in different time.
    Results: A diagnosis of hemoperitoneum and severe pre-eclampsia with liver and splenic bleeding was done and managed it with 3 xypho-pubic-laparatomy in different time with haemostatic packing.
    Discussion: In this case report, the patient underwent an emergency caesarean section and was managed with packing of hepatic and splenic hematomas and according to her haemodynamic clinical conditions was operated in different time. The choice of laparotomy and hepatic packing has proved to be a viable option in patients with unstable vital signs and is feasible even in limited resource settings.
    Conclusion: Short interval between diagnosis and management may enhance the feto-maternal survival rate and prevent further morbidity or mortality. The choice of laparotomy and hepatic packing has proved to be a viable option in patients with unstable vital signs and is feasible even in limited resource settings.
    Key words: HELLP syndrome, Liver hematoma rupture, Packing.
    MeSH term(s) Humans ; Female ; Pregnancy ; Adult ; HELLP Syndrome/diagnosis ; HELLP Syndrome/surgery ; Cesarean Section ; Hemoperitoneum/etiology ; Hemoperitoneum/surgery ; Liver ; Gastrointestinal Hemorrhage ; Hematoma/diagnosis ; Hematoma/etiology ; Hematoma/surgery
    Language English
    Publishing date 2023-09-04
    Publishing country Italy
    Document type Case Reports ; Journal Article
    ZDB-ID 418927-9
    ISSN 2239-253X ; 0003-469X
    ISSN (online) 2239-253X
    ISSN 0003-469X
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  2. Article ; Online: Focal liver lesions suspected of being cholangiocarcinomas.

    Zanini, Nicola / Jovine, Elio / Landolfo, Giovanni

    The American journal of gastroenterology

    2015  Volume 110, Issue 4, Page(s) 599

    MeSH term(s) Adenoma ; Bile Duct Neoplasms ; Bile Ducts, Intrahepatic ; Carcinoma, Hepatocellular ; Cholangiocarcinoma/diagnosis ; Focal Nodular Hyperplasia ; Hemangioma ; Humans ; Liver Neoplasms
    Language English
    Publishing date 2015-04
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.1038/ajg.2015.56
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  3. Article ; Online: Surgery for isolated liver metastases from pancreatic cancer.

    Zanini, Nicola / Lombardi, Raffaele / Masetti, Michele / Giordano, Marco / Landolfo, Giovanni / Jovine, Elio

    Updates in surgery

    2015  Volume 67, Issue 1, Page(s) 19–25

    Abstract: The resection of liver metastases from pancreatic ductal adenocarcinoma has been discouraged because it is commonly thought that it does not improve survival. However, the role of potential prognostic factors is unclear, and universally accepted ... ...

    Abstract The resection of liver metastases from pancreatic ductal adenocarcinoma has been discouraged because it is commonly thought that it does not improve survival. However, the role of potential prognostic factors is unclear, and universally accepted strategies have not been proposed. Between 2003 and 2014, 15 patients with isolated synchronous or metachronous metastases from pancreatic cancer underwent liver resection in our department. The role of potential prognostic factors was analyzed to predict survival. One right hepatectomy, 1 bisegmentectomy and 13 wedge resections were performed. Eleven patients underwent simultaneous pancreatic and liver resection for synchronous disease. The median overall survival (OS) was 9.1 months (95% CI 8.6-9.7). The only potential prognostic factor that significatively affected survival was the timing of metastases (metachronous vs. synchronous). Median OS in patients with metachronous disease was 11.4 months (95% CI 0-25.1) vs. 8.3 months (95% CI 6.9-9.7), p = 0.038. Surgery for liver metastases from pancreatic cancer is not suggested for most patients. If resection is considered, timing of metastatic disease could be a prognostic factor for survival after surgery.
    MeSH term(s) Adult ; Aged ; Biopsy, Fine-Needle ; Carcinoma, Pancreatic Ductal/diagnosis ; Carcinoma, Pancreatic Ductal/secondary ; Carcinoma, Pancreatic Ductal/surgery ; Endosonography ; Female ; Follow-Up Studies ; Hepatectomy/methods ; Humans ; Liver Neoplasms/diagnosis ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Neoplasm Metastasis ; Pancreatectomy/methods ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome
    Language English
    Publishing date 2015-03
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-015-0283-6
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  4. Article ; Online: Estimation of the prevalence of asymptomatic pancreatic cysts in the population of San Marino.

    Zanini, Nicola / Giordano, Marco / Smerieri, Elia / Cipolla d'Abruzzo, Giulio / Guidi, Marilyn / Pazzaglini, Giorgio / De Luca, Fiorella / Chiaruzzi, Giorgia / Vitullo, Giovanni / Piva, Paolo / Lombardi, Raffaele / Jovine, Elio / Gatti, Marino / Landolfo, Giovanni

    Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.

    2015  Volume 15, Issue 4, Page(s) 417–422

    Abstract: Background: There has been a dramatic increase in the number of pancreatic cystic lesions observed in the past two decades but data regarding the prevalence of cysts in the general population are lacking.: Methods: All the individuals who undergo CT ... ...

    Abstract Background: There has been a dramatic increase in the number of pancreatic cystic lesions observed in the past two decades but data regarding the prevalence of cysts in the general population are lacking.
    Methods: All the individuals who undergo CT at the San Marino State Hospital are residents of the Republic of San Marino; their demographic distribution is available and precise. CT scans carried out over 1 year at the State Hospital were reviewed for asymptomatic pancreatic cysts.
    Results: 1061 relevant CT scans were carried out on 814 patients; 762 individuals were eligible for the study and 650 patients underwent contrast-enhanced CT. Thirty-five patients had at least one cyst at contrast-enhanced CT (5.4%). The prevalence of cysts increased with increasing age up to 13.4% (95% CI 6.6-20) in individuals 80-89 years of age (p < .001). Cyst prevalence was significantly higher in patients who underwent CT for malignancy (p = .038) but this difference was no longer significant in multivariate analysis. The odds of a cyst being present increased by 1.05 (95% CI 1.02-1.09) for each increasing year of age (p = .002). Approximately a quarter of the patients with cysts died within 1 year after CT from non pancreas-related disease. The estimated standardized age-adjusted cyst prevalence is 2194 per 100,000 people.
    Conclusions: The likelihood of having a pancreatic cyst correlates with increasing age, not with the presence of extra-pancreatic malignancies. The estimated prevalence of CT-detectable asymptomatic pancreatic cysts in the general population is 2.2%.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Contrast Media ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Neoplasms/complications ; Neoplasms/epidemiology ; Pancreatic Cyst/diagnosis ; Pancreatic Cyst/epidemiology ; Pancreatic Cyst/mortality ; Prevalence ; San Marino/epidemiology ; Sex Factors ; Tomography, X-Ray Computed ; Young Adult
    Chemical Substances Contrast Media
    Language English
    Publishing date 2015-07
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2056680-3
    ISSN 1424-3911 ; 1424-3903
    ISSN (online) 1424-3911
    ISSN 1424-3903
    DOI 10.1016/j.pan.2015.05.461
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    Zs.A 5553: Show issues Location:
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  5. Article ; Online: Analysis of prognostic factors in metastatic tumors of the pancreas: a single-center experience and review of the literature.

    Masetti, Michele / Zanini, Nicola / Martuzzi, Federica / Fabbri, Carlo / Mastrangelo, Laura / Landolfo, Giovanni / Fornelli, Adele / Burzi, Marcellino / Vezzelli, Elena / Jovine, Elio

    Pancreas

    2010  Volume 39, Issue 2, Page(s) 135–143

    Abstract: Objectives: Pancreatic metastases are rare. The role of surgery is poorly defined, and data on long-term survival are lacking.: Methods: Data from patients with pancreatic metastases observed in our division from 2003 to 2008 were retrospectively ... ...

    Abstract Objectives: Pancreatic metastases are rare. The role of surgery is poorly defined, and data on long-term survival are lacking.
    Methods: Data from patients with pancreatic metastases observed in our division from 2003 to 2008 were retrospectively analyzed. In addition, the recent English medical literature was reviewed regarding series of patients with pancreatic secondary tumors.
    Results: Data from 234 patients including 9 consecutive patients observed in our division were retrieved. Metastasis from renal cell carcinoma accounted for 67.9% of all cases. Factors predictive of worse survival, as determined by multivariate analysis, were symptoms at diagnosis, synchronous tumors, radical-intent surgery not performed, and pathologic diagnosis of the primary tumor. Compared with pancreatic metastases from renal cell cancer, metastases from melanoma (P < 0.001) and lung cancer (P = 0.002) were associated with worse survival. The differences in survival of patients with renal cell cancer metastases and those with breast cancer, colorectal, or sarcoma metastases did not reach statistical significance.
    Conclusions: There may be a subset of patients with pancreatic metastases who are able to benefit from surgery with respect to improved long-term survival. Symptoms at diagnosis, presentation with primary tumor, surgical resection, and pathologic diagnosis seem to be important prognostic factors.
    MeSH term(s) Adult ; Aged ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/secondary ; Pancreatic Neoplasms/surgery ; Patient Selection ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2010-03
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 632831-3
    ISSN 1536-4828 ; 0885-3177
    ISSN (online) 1536-4828
    ISSN 0885-3177
    DOI 10.1097/MPA.0b013e3181bae9b3
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  6. Article: Immunocytochemical increased evidence of inducible nitric oxide synthase, tumor necrosis factor-alpha, and adrenocorticotropic hormone in human peritumoral lymph nodes.

    Rossi, Aldo / Landolfo, Giovanni / Sassi, Davide / Franchini, Antonella / Ottaviani, Enzo

    Applied immunohistochemistry & molecular morphology : AIMM

    2002  Volume 10, Issue 1, Page(s) 52–56

    Abstract: In the current study, mesenteric and peritumoral lymph nodes surgically removed from patients with colon-rectum cancer were studied. Morphologic and immunocytochemical investigations demonstrated that mesenteric (control) and peritumoral lymph nodes of a ...

    Abstract In the current study, mesenteric and peritumoral lymph nodes surgically removed from patients with colon-rectum cancer were studied. Morphologic and immunocytochemical investigations demonstrated that mesenteric (control) and peritumoral lymph nodes of a same patient showed the same morphologic structure, but a different immunocytochemical pattern. Indeed, an increased immunoreactivity to anti-inducible nitric oxide synthase, anti-tumor necrosis factor-alpha, and anti-adrenocorticotropic hormone antibodies in the lymphatic tissue of peritumoral lymph nodes compared with mesenteric lymph nodes was observed. These findings suggest that in colon-rectum cancer, the pathologic event induces an increased expression of the molecules involved in the processes of inflammation and carcinogenesis that occurs earlier than the appearance of morphologic modifications.
    MeSH term(s) Adrenocorticotropic Hormone/metabolism ; Aged ; Aged, 80 and over ; Female ; Humans ; Image Processing, Computer-Assisted ; Immunohistochemistry ; Lymph Nodes/enzymology ; Lymph Nodes/metabolism ; Lymphatic Metastasis ; Male ; Middle Aged ; Nitric Oxide Synthase/metabolism ; Nitric Oxide Synthase Type II ; Tumor Necrosis Factor-alpha/metabolism
    Chemical Substances Tumor Necrosis Factor-alpha ; Adrenocorticotropic Hormone (9002-60-2) ; NOS2 protein, human (EC 1.14.13.39) ; Nitric Oxide Synthase (EC 1.14.13.39) ; Nitric Oxide Synthase Type II (EC 1.14.13.39)
    Language English
    Publishing date 2002-02-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1541-2016
    ISSN 1541-2016
    DOI 10.1097/00129039-200203000-00009
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  7. Article ; Online: Muscle psoas metastasis from uterine squamous cell carcinoma.

    Jovine, Elio / Smerieri, Elia / Mulas, Maria M / Mastrangelo, Laura / Landolfo, Giovanni / Biolchini, Federico / Fornelli, Adele

    ANZ journal of surgery

    2008  Volume 78, Issue 3, Page(s) 213–214

    MeSH term(s) Adult ; Biopsy, Needle ; Carcinoma, Squamous Cell/secondary ; Carcinoma, Squamous Cell/therapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy/methods ; Immunohistochemistry ; Muscle Neoplasms/pathology ; Muscle Neoplasms/secondary ; Muscle Neoplasms/surgery ; Neoplasm Staging ; Psoas Muscles ; Radiotherapy, Adjuvant ; Reoperation ; Risk Assessment ; Treatment Outcome ; Uterine Neoplasms/pathology ; Uterine Neoplasms/therapy
    Language English
    Publishing date 2008-03
    Publishing country Australia
    Document type Case Reports ; Letter
    ZDB-ID 2050749-5
    ISSN 1445-2197 ; 1445-1433 ; 0004-8682
    ISSN (online) 1445-2197
    ISSN 1445-1433 ; 0004-8682
    DOI 10.1111/j.1445-2197.2007.04410.x
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  8. Article: Intrahepatic rupture of a caudate lobe adenoma in liver adenomatosis.

    Jovine, Elio / Biolchini, Federico / Talarico, Fernando / Lazzari, Andrea / Lerro, Federica M / Selleri, Simonetta / Landolfo, Giovanni / Martuzzi, Federica

    Journal of hepato-biliary-pancreatic surgery

    2004  Volume 11, Issue 5, Page(s) 324–329

    Abstract: Hepatic adenomatosis is a rare benign disease that is more common in young and middle-aged women who are non-steroid dependent; it is usually symptomatic, progressive, and susceptible to hemorrhagic complications. Malignant transformation within adenomas ...

    Abstract Hepatic adenomatosis is a rare benign disease that is more common in young and middle-aged women who are non-steroid dependent; it is usually symptomatic, progressive, and susceptible to hemorrhagic complications. Malignant transformation within adenomas is rare. The management of hepatic adenomatosis remains difficult due to the absence of predictive signs of complications, other than the size of the adenomas. Resective surgery is usually indicated, but liver transplantation could be an indication in highly symptomatic or progressive forms of the disease and represents the treatment of choice in cases of malignant transformation. We report a case of intrahepatic rupture of a caudate lobe adenoma which occurred in an adolescent with hepatic adenomatosis; we also present a brief review of the literature.
    MeSH term(s) Adenoma/blood ; Adenoma/complications ; Adenoma/surgery ; Adolescent ; Female ; Hepatectomy ; Hepatic Artery/diagnostic imaging ; Humans ; Liver Neoplasms/blood ; Liver Neoplasms/complications ; Liver Neoplasms/surgery ; Magnetic Resonance Imaging ; Radiography ; Rupture
    Language English
    Publishing date 2004
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1181222-9
    ISSN 1436-0691 ; 0944-1166
    ISSN (online) 1436-0691
    ISSN 0944-1166
    DOI 10.1007/s00534-003-0891-2
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    Zs.A 4024: Show issues Location:
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  9. Article: Chirurgia colo-rettale laparoscopica: e necessaria la "curva di apprendimento"?

    Jovine, Elio / Talarico, Fernando / Bolchini, Federico / Landolfo, Giovanni / Mastrangelo, Laura / Lerro, Maria Federica / Martuzzi, Federica / Selleri, Simonetta / Lazzari, Andrea / Iusco, Domenico Rosario / Gizzi, Giuseppe

    Annali italiani di chirurgia

    2005  Volume 76, Issue 2, Page(s) 183–187

    Abstract: Aim of the study: To present the early experience of the Authors' division in the field of colorectal laparoscopic surgery, in order to evaluate the so-called "learning curve".: Materials and method: From February 2003 to May 2004, we have performed ... ...

    Title translation Laparoscopic colorectal surgery: is the "learning curve" necessary?.
    Abstract Aim of the study: To present the early experience of the Authors' division in the field of colorectal laparoscopic surgery, in order to evaluate the so-called "learning curve".
    Materials and method: From February 2003 to May 2004, we have performed 220 surgical procedures for colorectal pathology: 63 were conducted by a laparoscopic approach with 10 patients who, converted to a laparotomic procedure in theatre, were not taken under consideration. The present work is thus based on a population of 53 patients, 27 men and 26 women, at a median age of 64.4 y.o. (range 42-81).
    Results: We performed 1 total colectomy, 24 right hemicolectomy, 1 resection of the splenic flexure, 12 left hemicolectomy (in 1 case a left hepatic lobectomy was associated), 11 anterior resection of the rectum, 1 Hartmann' sigmoid resection and 3 abdomino-perineal resection. Mean operative time was 200.34 +/- 64.17 min, while the mean hospital stay was 6.44 +/- 2.68 days. Peri-operative mortality was 0%, 30-days mortality was 1/53 patients (9%) while morbidity was 5/53 patients (9.4%): in 2 cases reintervention was necessary.
    Discussion: From the evaluation of the results, we found some significant data: first, the conversion rate was similar to those reported by other authors, so also the mortality and morbidity rates.
    Conclusions: The advantages of the laparoscopic technique, indirectly documented by shorter in-hospital stay. At least for patients submitted to right or left hemicolectomy without complications (5.5 e 5.7 days, respectively), could be seen also after only a 1 year of activity. As far as the "learning curve" is concerned, dividing our activity into 3 times, we verified a progressive shortening of the operative time and, at least for the patients submitted to a right emicolecomy, also of the morbidity rates.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Colectomy ; Colorectal Neoplasms/surgery ; Colorectal Surgery/methods ; Female ; Humans ; Laparoscopy ; Laparotomy ; Learning ; Length of Stay ; Male ; Middle Aged ; Time Factors
    Language Italian
    Publishing date 2005-03
    Publishing country Italy
    Document type English Abstract ; Evaluation Studies ; Journal Article
    ZDB-ID 418927-9
    ISSN 2239-253X ; 0003-469X
    ISSN (online) 2239-253X
    ISSN 0003-469X
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