Browsing by Author "Aslan, Firat"

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Endoscopic Management of Cystic Stump Leaks: Insights From a Tertiary Care Center
(Turkish Assoc Trauma Emergency Surgery, 2025) Aslan, Firat; Bozkurt, Halil Alper; Yilmaz, Abdullah Hilmi; Binici, Serhat
BACKGROUND: Cystic stump leakage is the most common cause of bile leakage following cholecystectomy, representing a significant postoperative complication that requires prompt intervention. Currently, endoscopic treatment is the preferred management approach. This study aims to identify factors influencing the success of endoscopic therapy for cystic stump leaks by analyzing cases treated at our institution. METHODS: Thirty-seven patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for cystic stump leakage were included in this study. Patient demographics, associated complications, and length of hospital stay were analyzed. RESULTS: All patients showed clinical improvement, with a mean hospital stay of 5.1 days. The presence of comorbidities, emergency surgery, or conversion to open surgery did not significantly impact treatment efficacy. Post-procedure, percutaneous drainage was required in 10 patients (27%). Procedure-related pancreatitis was noted in one patient (2.7%). Statistical analysis revealed that both the need for percutaneous drainage and the length of hospital stay were significantly lower in patients who had pre-existing drains (p<0.03). Additionally, early ERCP was associated with a significantly shorter hospital stay (p<0.01). CONCLUSION: Stent placement via ERCP is a safe and effective strategy for managing cystic stump leaks. Early ERCP intervention following cystic stump leak detection is recommended. Furthermore, percutaneous drainage may be necessary in patients who do not respond adequately to initial treatment.
Linking Cdh1 Snps To Gastric Cancer Risk: a Comprehensive Analysis of Rs16260, Rs13689, and Rs9929218
(Springer, 2024) Aslan, Firat; Almali, Necat; Kaya, Zehra; Guven, Mustafa; Sahin, Elif Sena; Ozdemir, Abdulselam; Uygur, Serhat
Objective Single nucleotide polymorphisms (SNPs) are linked to carcinogenesis. Pathogenic variants in the CDH1 gene are associated with gastric cancer. This study examines the genotype and allele frequencies of three SNPs (rs16260, rs13689, and rs9929218) in the CDH1 gene and their relationship with gastric cancer risk. Materials and methods The study involved 105 gastric cancer patients with pathology results and 105 healthy controls. Clinical, histopathological, and demographic data were collected and compared between the two groups. Results No significant differences were found for rs16260 (- 160 C > A) and rs9929218 (G > A) between patients and controls (p > 0.05). For rs13689 (T > C), the T allele frequency was 90% in patients versus 69% in controls, while the C allele frequency was 10% in patients versus 31% in controls. A significant difference was observed for this SNP, with a higher T allele frequency in patients (OR = 4.03 CI95% 2.4-6.7, p < 0.0001) compared with controls, suggesting a fourfold increased risk of gastric cancer. Genotype frequencies were 80% wild-type (TT) and 20% heterozygous-type (TC) in patients, and 58% TT, 22% TC, and 20% mutant-type (CC) in controls (p < 0.0001). The frequencies of non-C allele carriers (TT) were present in 80% of patients versus 58.1% of controls (OR = 2.88 CI95% 1.56-5.34, p = 0.0006). Conclusion This study is the first to link the rs13689 SNP's T allele and TT genotype with increased gastric cancer risk. Our results suggest that the rs13689 T allele may contribute significantly to disease susceptibility, while the rs16260 CC genotype and rs9929218 GG genotype may influence risk in smokers.
Reference Values for Normal Main Portal Vein Diameter in Subjects Aged 1-80 Years
(SpringerNature, 2025) Binici, Serhat; Aslan, Firat; Yanc, Ugur; Eryilmaz, Iklil; Tahiroglu, Veysel; Beger, Burhan; Beger, Orhan
Purpose Demographic features of subjects such as body mass index, height, weight, age or sex affect diameters of vessels like main portal vein (MPV). Some articles use different anatomical indicators like L1's body for creating a complete standard while diagnosing venous pathologies. This work aimed to display relationships of portal veins with L1 in normal subjects aged 1-80 years. Methods Abdominopelvic computed tomography views of 800 subjects were included in the work. The diameter of left (LPV) and right (RPV) branches of MPV, and the diameter of MPV at the distal level (MPV1), the middle level (MPV2), and the proximal level (MPV3) were measured. The transverse diameter of L1's body (L1TD) was measured. The ratios of vein diameters to L1TD were calculated. Results Age affected the diameters of portal veins and L1's body. L1TD increased until the early 50 s, but thereafter showed no statistically significant change. The diameters of portal veins increased from birth to approximately the early 50 s, but then decreased statistically. Moreover, MPV1 / L1TD, MPV2 / L1TD and MPV3 / L1TD generally showed a pattern of first increasing and then decreasing with advancing age, whereas RPV / L1TD and LPV / L1TD showed a pattern of decreasing with advancing age. L1TD was greater in males than females (p < 0.001). MPV1, MPV2, MPV3, RPV and LPV were statistically similar for both sexes (p > 0.05). Conclusion Age-specific diameter measurements and calculated ratios in our study may be useful for clinicians to diagnose disorders regarding portal system in pediatric and adult subjects.
Surgical Treatment in Synchronous Oesophageal Cancers - A Systematic Review on Survival Outcomes
(Elsevier Sci Ltd, 2025) Bartin, Mehmet Kadir; Dogan, Ibrahim; Aslan, Firat
Objective: It is crucial to consider that other primary cancers may co-occur with synchronous oesophageal cancers when evaluating and deciding on treatment. This research aimed to assess available information on the viability and safety of synchronous resection of oesophageal carcinomas. Methods: A systematic literature search was conducted on PubMed, Scopus, Cochrane Central Register of Controlled Trials, and EMBASE to identify 34 peer-reviewed articles up to 2025. It included randomised controlled trials (RCTs), controlled clinical trials, observational studies, cohort studies, and case-control studies with adult patients (>= 18 years) undergoing surgery. Results: Studies on the surgical management of oesophageal cancer metastasis revealed that the median overall survival within 1-3 years ranged from 21.% % to 32 %. In one study, the 5-year median survival was 38.8 % in TTE and 23 % in esophagectomy plus gastrectomy. Regarding data on case series, concomitant stomach and oesophageal neoplasms were present in 89 patients (76 % of the overall group). Seventy-five patients had adenocarcinomas, whereas the remaining 10 patients had gastrointestinal stromal tumours (GISTs). Eighty-seven patients had a transthoracic echocardiogram (TTE), one patient had a transhiatal esophagectomy (THE), and one patient had a thoracoabdominal approach. The remaining 59 patients had gastrectomies that left some stomach tissue intact. In 93 % of the patients, the second primary tumour could be diagnosed prior to surgery. Conclusion: Concurrent resection of oesophageal and other primary solid organ cancers is safe, technically possible, and linked to acceptable perioperative death rates on an individual basis.