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Aims: Spleen masses, which are discovered on imaging studies, usually create difficulty in diagnosis and treatment. Except for lymphomas involving the spleen, primary and secondary neoplasms are rare and discovered by chance. This study analyses a series of splenectomies in a surgical clinic to evaluate the management of incidentally diagnosed splenic masses. Study Design: This retrospective study included patients operated for spleen masses between 2010 and 2021. Patients with a history of lymphoproliferative disease and splenectomy performed as part of a larger resection were excluded. Methodology: The patients were divided into three groups, i.e. cystic, benign and malignant, based on the results of pathological examinations. The groups were compared in terms of age, gender, tumor size, and previous history of malignancy. Results: Splenectomy was performed in 512 patients in 11 years, 62 of whom had solid and cystic lesions detected on imaging. Thirty-five patients (56,5%) were female and the median age was 40 years (range: 18-80 years). Forty-four patients (71%) had distinct symptoms. Radiological evaluations of all the patients were made. Diagnostic biopsy could not be performed in any of the patients. The final pathological examination showed cysts in 38 patients (61,3%), benign lesions in nine patients (14,5%) and malignant lesions in 15 patients (24,2%). Out of 15 patients with malignant lesions, one patient had Hodgkin’s lymphoma, four patients had diffuse large B cell lymphoma and ten patients had metastatic tumors. There was a significant difference in age between the groups and the malignant group was older (p = 0.017). The size of the lesions also significantly differed and the malignant lesions had a significantly smaller diameter (p = 0.014). A significantly higher rate of the malignant group had a previous history of cancer (p˂0,001). Conclusion: Spleen neoplasms are masses that are difficult to diagnose. Most of them are asymptomatic and are found after splenectomies by coincidence. Splenectomy can be utilized as both a diagnostic and curative method. It should be kept in mind that the lesions detected in the spleen in patients with a history of malignancy can be metastatic.

Objective:This study aimed to investigate the factors associated with pancreatic fistula (PF) development after pancreaticoduodenectomy (PD) at our clinic.Methods:Patients who underwent PD for periampullary tumours between 2010 and 2019 were included in the study and categorised into Group I (with PF) and Group II (without PF). The demographic and clinical characteristics, laboratory parameters, tumour characteristics and post-operative results were compared between the groups. Risk factors for PF were analysed by univariate analysis and multivariate logistic regression analysis.Results:In total, 155 patients participated in the study (Group I: n=31; Group II: n=124). The rate of PF was 20%. The two groups were comparable with regard to sex (p=0.348) and age (64.8 vs 66.9 years, p=0.916). Compared with Group II, Group I had a higher number of metastatic lymph nodes (1.61 vs 0.87, p=0.041), a higher number of post-operative complications (58.1% vs 21.8%, p=0.000) and a longer duration of post-operative hospital stay (25.25 vs 16.43 days, p=0.000). Haemoglobin (p=0.493) and albumin (p=0.698) levels were similar between the groups. Total survival duration was shorter in Group I (23.9 vs 38.18 months, p=0.024). In multivariate analyses, being ≥65 years (p=0.040), tumour localisation (p=0.021), lymph node stage (p=0.008) and performedtumour diameter ≥2 (p=0.021) were the independent risk factors for developing pancreatic fistula.Conclusion:In our study, tumour diameter, patient age and lymph node status were associated with PF development. The development of PF reduced expected survival. We believe that identifying the preoperative, intraoperative and post-operative factors related to PF formation may help decrease its development.

Aims: Mucinous, medullary, and papillary carcinomas are rarely encountered types of breast cancer. This study aims to contribute to the literature by comparing the clinical and prognostic features and treatment alternatives of rare breast carcinomas. Study Design: Thirty-four patients with rare breast cancer out of a total of 1368 patients who underwent surgery for breast cancer in our clinic between January 2011 and December 2020 were included in the study. Methodology: The patients were assigned into three groups, i.e., medullary carcinoma group (Group 1), mucinous carcinoma group (Group 2) and papillary carcinoma group (Group 3). Demographic and clinical features, treatment modalities used, surgical approaches, pathological features of tumors and survival were compared between the groups. Results: Thirty-four patients were included in the study. The mean age of the patients in Group 3 was higher, though it was not statistically significant. Modified radical mastectomy was more frequently performed in all the groups. The number of the lymph nodes removed through axillary dissections and the number of the positive lymph nodes were similar in all the groups. The tumors in all the groups were also of comparable sizes (30 mm in Group 1, 42.5 mm in Group 2 and 30 mm in Group 3; p:0.464). Estrogen receptors were negative in a significantly higher rate of Group 1(66.7% of Group 1, p

Aim:In this study, we aimed to share our surgical experiences and clinical results in non-traumatic small bowel perforations.Method:Patients who underwent surgical treatment for non-traumatic small bowel perforation between 2009-2019 were included in the study. Patients were divided into two groups according to postoperative 90-day mortality status: Group 1 (no mortality), Group 2 (mortality). The demographic, clinical features, treatment methods and results of the patients were compared between the groups.Results:Forty-two patients participated in our study. Group 1 consisted of 25, and Group 2 consisted of 17 patients. Male sex was dominant in Group 2 (48% vs 76.5%, p=0.062). Mean age was higher in Group 2 (54 vs 61, p=0.218). American Anesthesiology Association score (ASA) was statistically significantly higher in Group 2 (12% vs 58.8%). Forty-two percent of patients had abdominal surgery and 30% had a history of malignancy. The presence of electrolyte imbalance was similar in the groups (56% vs 76.5%, p=0.049). The days between the first complaint and laparotomy were similar between the groups (6.40 vs. 5.70 p=0.699). In perforated areas, jejunum was dominant in Group 2 with 64.7%, and ileum in Group 1 with 68%. The multiple perforation rate was higher in Group 2, but was not statistically significant (12% vs 23.5%, p=0.284). From postoperative complications, anastomosis leakage was higher in Group 1, but it was not statistically significant (12% vs 5.9%, p=0.501).Conclusion:Morbidity and mortality of non-traumatic small bowel perforations is high. While the ASA score and hypoalbuminemia were associated with postoperative mortality in non-traumatic small bowel perforations, we did not find the localization of the perforation and the time between the first complaint and laparotomy to be related to mortality.

Gallstone ileus occurs when a gallstone passes into the intestinal system through a fistula between the gallbladder or biliary tract, and the duodenum, stomach or colon, and causes an obstruction. Although it is usually seen in advanced ages, it has rarely been reported in patients who are 100 years old. A 100-year-old female patient, without significant medical or surgical history, was admitted to the emergency department for diffuse abdominal pain, nausea, vomiting, and constipation. Abdominal computed tomography showed air in the biliary tract and obstruction in the small intestine. Patient was operated under emergency conditions. Enterolithotomy was performed and the stone was extracted. Postoperative recovery was uneventful. Bilioenteric fistulas, a major complication of chronic gallbladder diseases, usually develop secondary to intense inflammation. Patients’ age, concomitant disease, clinical condition and intraoperative findings should be taken into consideration while planning the treatment. The data in the literature generally supports the employment of enterolithotomy in high-risk patients and reserves cholecystectomy and resection of the fistula for less comorbid patients with feasible anatomy.

Background: Appendix tumors are rare tumors found in the gastrointestinal tract, observed at a rate of about 0.2%–0.3%. Our aim in this study was to present the clinicopathological classification, treatment and long-term prognosis of patients with low grade appendiceal mucinous neoplasm (LAMN). Methods: Patients who underwent surgery in the Erciyes University Department of (Kayseri, Turkey), Department of General Surgery between December 2010 and December 2018, and who had LAMN as a result of pathology were included in our study. Demographic data, clinical and pathological features of the disease, their treatment and follow-up results after treatment were reviewed retrospectively. Results: We included 24 patients in the study. Of these patients, 10 (41.6%) were male. The mean age distribution was 56.4 ± 20.3 (21–91) years. Appendectomy was performed in 14 patients, and additional organ resections were performed in 8 patients. The most common symptom at the time of presentation was abdominal pain (79.1%; 95% CI, 58.3–91.7). The most common preliminary diagnosis in the preoperative period was acute appendicitis (50%; 95% CI, 29.2–70.8). Mean postoperative hospitalization time was 7.4 ± 7.96 (2–31) days. On pathological examination, appendectomy resection margins were positive in two patients. The mean (median) postoperative follow-up was 31.25 ± 23.9 (27) (1–90) months. One-year survival was 91.6%, and 5-year survival was 83.3%. Recurrence was detected in three patients during the follow-up period. Conclusion: If appendix mucinous neoplasia (AMN) is suspected in patients undergoing surgery with an initial diagnosis of acute or plastron appendicitis, care should be taken to remove the lesion without perforation. Pseudomyxoma peritonei, which may develop as a result of perforation, is associated with recurrence and decreased survival.

Purpose: A significant number of the protective stomas temporarily applied in order to reduce the effects of anastomosis complications after rectal cancer surgery cannot be closed and become permanent. In this study, the causes that can lead to a permanent stoma were investigated.Materials and Methods: Patients who underwent elective surgery with low anterior resection and protective ileostomy due to rectal cancer were included in the study. Patients whose stoma could not be closed within one year were evaluated as permanent stoma.Results: 66 patients were included in the study. The mean closing time for the stomas were found as 5, 6 +2,5 (1-12)months. The stomas of twelve (18.2%) of the patients could not be closed and became permanent. The presence of metastatic disease at the time of diagnosis, the proximity of the anastomosis to the anal entry, coloanal anastomosis, and the final pathology showing stage IIIC were found to be risk factors for permanent stoma.Conclusion: Some of the stomas applied temporarily due to surgical treatment of rectal cancer became permanent. Before the index operation, the patient and their relatives should be informed that in the presence of certain risk factors, these stomas may not be closed and become permanent.

Objectives: The aim of this study was to assess whether ultrasound-guided (US-guided) percutaneous drainage of breast abscesses could be used as an alternative to surgery. Methods: We performed a retrospective study. Twenty patients were included in the study who were diagnosed as having a non-specific breast abscess. Eleven patients underwent surgery whereas nine patients were treated with US-guided drainage. Ultrasonographic findings, results of treatment and follow-up were evaluated between the two groups. Results: In the US-guided drainage group, 5 patients were treated with needle aspiration and 4 were treated with catheter drainage. All cases within the needle aspiration group totally recovered. However, one case within the catheter drainage group failed. The total success rate of US-guided drainage was 88.8%. The median follow-up period was 21.0 days in the US-guided drainage group and 45.0 days in the surgical drainage group. There were no statistically significant differences in terms of recovery (p = 0.450) and follow-up periods (p = 0.112) between the surgical drainage and US-guided drainage groups. Conclusions: US-guided percutaneous drainage may be preferred as a first method of choice in treatment of a breast abscess. The most appropriate approach to breast abscess treatment will be possible with a multidisciplinary approach of surgery and radiology.

Künt abdominal travmanın neden olduğu izolejejunal perforasyon nadirdir ve çoğu kez motorlu taşıt kazalarından sonra veyüksekten düşmeler sonrası görülür. Bu yazıda ; acil servise yüksekten düşmeşikayeti ile başvuran ve ilk muayene, radyolojik incelemeleri normaldeğerlendirilen künt karın travmalı bir olgunun müşahede altında ikentekrarlanan fizik muayene ve kontrol görüntülemeleri ile 24 saat sonra tespitedilen izole jejnum perforasyonu sunulmuştur. Künt travmalı hastalarda da izole ince bağırsak yaralanmasıolabileceği düşünülerek yapılan tetkik ve muayenelerin normal olduğu durumlarda bile, tekrarlayan fizikmuayenelerle hastaları takip etme, görüntüleme ve müşahede süresini uzatmanınönemi büyüktür Bu tür travmaolgularının gözlem altında tutulması hayati sorunların tespiti için sonderece önemlidir .Erken tanı ve tedavi olası komplikasyonların ve mortaliteninönlenmesi açısından önemlidir., Isolated jejunal perforation caused by blunt abdominal trauma is rare andmost often seen after motor vehicle accidents and falling down from height. Inthis article, a case of blunt abdominal trauma which was admitted to theemergency department with the complaint of falling from the high places is presented. Even though the first physical and radiological examinationswere normal, isolated jejunal perforation was detected in control examinationsand control radiological images while the patient was under observation.Control examinations, control radiological images and prolonging theobservation time are very important even when the examinations performed withthe idea of isolated small bowel injury in blunt trauma patients are normal.Keeping such trauma cases under observation is extremely important to detect life threatening problems. Early diagnosis and treatment is veryimportant for prevention of possible complications and mortality.

Background: In this study, we aim at investigating the effect of post partial hepatectomy Ankaferd blood stopper (ABS) on liver regeneration in rats. Methods: Twenty-four rats were included in our study divided into three groups. (Group A = (Sham) 8 rats, Group B = (control) 8 rats, Group C = (experimental) 8 rats). Two-thirds hepatectomy was employed in all rats. Intraperitoneal 0.9% saline was administered to the rats in the control group, and intraperitoneal 1 ml Ankaferd was administered to the rats in the experimental group. The rats were sacrificed on the 7th day. Tissue samples were taken from the liver tissue for histopathological evaluation. Results: The number of mitosis and the cytoplasmic vacuolization/hdyropic degeneration scores were statistically different between the groups (Group A: 11.63 vs Group B: 17.00 vs Group C: 8.88 (p:0.028) and Group A: 8.56 vs Group B: 16.63 vs Group C: 12.31 (p:0.034), respectively). The presence of binuclear hepatocytes score was p: 0.258 and disorganized distribution in cell proliferation in the parenchyma score was :0.076; There was no statistical difference between the groups. The number of mitosis was p:0116 for Group A-B, p:1.00 for Group A-C and p:0.017 for Group B-C Conclusions: Positive results indicating an increase in liver regeneration due to Ankaferd were not obtained in our study.

Aim:In the present study, we aimed to investigate the seasonal characteristics of presentations to the hospital due to diverticular disease.Method:The patients who were admitted to the hospital between January 1st, 2015 and January 1st, 2020 due to diverticular disease were included in the study. The study was designed retrospectively. The patients were divided into groups according to the treatment method, namely Group 1: patients who received surgical treatment, and Group 2: patients who received medical treatment. Age, sex and seasonal periods were compared. Also, the patients were separated into three groups according to age: those between 18 and 40 years of age, those between 40 and 60 of age and those over 60 years of age. The sex and the treatment methods of the patients were also examined in the season groupsResults:One hundred fifty seven patients participated in our study. Group 1 consisted of 39 patients and Group2 consisted of 118 patients. Presentations to the hospital with acute diverticulitis occurred most frequently in the winter (39.5%). The average age was higher in Group 1 (60.61 vs 54.42, p=0.030). The sex distribution was similar in the groups (p=0.152). Winter was dominant in treatment groups (30.8% vs 42.4% p=0.060). In winter, the average age of the patients who received surgical treatment was higher than those who received medical treatment (68 vs 50 p=0.001). In winter, all patients who received surgical treatment were over 60 years of age. In summer, the ratio of patients who received medical treatment was highest for the group over 60 years of age (p=0.040).Conclusion:In our study, we displayed the seasonal change in hospital admissions due to diverticular disease. We detected an increased rate of presentations to the hospital in winter. Selection of the treatment method did not display a seasonal variation. However, when we made an additional evaluation according to the age groups, it was seen that greater number of patients who were older than 60 years received surgical treatment in winter whereas the greater number of them received medical treatment in summer. Pathophysiological mechanism of this change could not be fully revealed.

Aim:We aimed to determine the clinical value of erythrocyte distribution width (RDW) and mean platelet volume (MPV) in the diagnosis of acute appendicitis (AA) and in determining the severity of the disease.Method:Patients who were operated between January 2013 and January 2020 with a preliminary diagnosis of AA were included in the study. The patients were divided into two groups as Group 1 negative appendectomy and Group 2 acute appendicitis. In addition, Group 2 is divided into subgroups as a:perforated and b: non-perforated. RDW and MPV were compared between the groups and subgroups.Results:A total of 861 patients participated in our study. Group 1 consisted of 144 patients and Group 2 consisted of 717 patients. The mean age was similar in both groups (33.02 vs 35.34, p=0.088), female sex was higher in Group 1 (52.8% vs 42.9, p=0.019), RDW was higher in Group 1 (14.03 vs 13.67, p=0.007), MPV was similar between the groups (8.81 vs 8.95, p=0.363). RDW was an independent risk factor in the diagnosis of AA in multivariate analysis (odds ratio 0.604, 95% confidence interval (minimum-maximum) 0.420-0.868, p=0.006). RDW and MPV were independent variables in the diagnosis of perforated appendicitis in multivariate logistic regression analysis.Conclusion:RDW is a useful parameter in the diagnosis of AA and in determining the severity of the disease. However, MPV value does not have sufficient diagnostic value.

BACKGROUND

Purpose: To evaluate the effects of meperidine on fascial healing. Methods: Seventy adult male Sprague-Dawley rats divided into 7 groups with 10 rats in each group. One of these groups was determined as the sham group, 3 of the remaining 6 groups as meperidine groups, and 3 as control groups. These were grouped as 1st, 2nd, and 6th weeks. In the anterior abdominal wall of the rat, the skin was detached and a wound model including the peritoneum was created with a median incision. Mice in the meperidine group were injected with meperidine intraperitoneally (IP) 3 × 20 mg/kg meperidine on postoperative days 0, 1 and 2, and 2 × 20 mg/kg meperidine on postoperative days 3, 4, 5, and 6 after surgical intervention. Similar to the control group, an equal volume of saline was administered, corresponding to the doses. After sacrifice, the midline fascia was used for facial tensile strength measurement, and the other for histopathological analysis. Results: When compared, the meperidine and control groups inflammatory cell density was higher in the 1st week (p < 0.05) in the meperidine group, fibroplasia density was found to be higher at the 2nd week in the meperidine group than the control group (p < 0.05) When the tensile strength in the meperidine and control groups were compared, there was no significant difference (p > 0.05) at each of the three weeks. Conclusion: The application of postoperative systemic meperidine affects positively wound healing in the inflammatory stage and fibroplasia without changing the resistance to traction.

Aim: We aimed to evaluate (immunohistochemically) the YAP expression in breast cancer patients undergoing neoadjuvant chemotherapy and to clarify the relationship between the molecular characteristics, treatment response and survival data and the YAP expression, and hence, to clarify the prognostic significance. Methods: One hundred and four patients who were admitted to Erciyes University Faculty of Medicine after the approval of the Ethics Committee and were diagnosed with Breast Cancer between 2015-2020 and underwent NeoAdjuvant Chemotherapy were included in the study. The diagnoses of these patients were determined by any of the methods of Breast USG, Mammography, Breast MRI and, if necessary, PET/CT, and among pathological samples, Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal Growth Receptor-2 (HER2) and Ki-67 Expression are routinely stained immunohistochemically. In this study, existing immunohistochemical markers were reviewed and also, the relationship of YAP with these biological markers was evaluated by using immunohistochemistry and its effect on prognosis has been investigated. Results: The average age of the patients was 52.37. While YAP was positive in 78 patients (75%), it was negative in 26 patients (25%). In the evaluation after neoadjuvant therapy, pathological complete response (Miller Payne Grade 5 response) in 28 patients (26.9%), relapse in 6 patients (5.8%), and exitus in 6 patients (5.8%) were detected. In the pathological evaluation, invasive Ductal Carcinoma was the most common one observed in 88 patients (84.6%). As a result of the statistical evaluation, no significant result was obtained between the parameters and YAP negative / positive. Conclusion: As a result of staining with additional YAP in patients who were diagnosed with breast cancer and routinely stained with ER, PR, Cerb B2 and Ki-67 in pathology samples, we could not reach a result that would contribute positively to survival. Longer studies to be conducted prospectively will be meaningful.

Background Sepsis is a systemic inflammatory response to infection and is one of the leading causes of morbidity and mortality. The second hit after trauma causes increased inflammatory response and multiple organ failure (MOF). The infection which develops after burn injury is a suitable model for a two-hit trauma study. Sepsis causes the release of biochemical mediators, such as Free Oxygen Radicals (FORs), which may lead to lipid peroxidation, which may play a key role in multiple organ failure. In this study, we aimed to investigate the effects of phosphodiesterase (PDE) inhibitors (sildenafil, milrinone, pentoxifylline) and N-acetylcysteine (NAS) on oxidative stress and organ damage in two-hit models. Methods In this experimental study, peritonitis was created by cecal ligation and puncture (CLP) method in 40 rats, 72 hours after creating a 30% scalding injury. Rats were divided into five groups of eight rats each as follows: Group I: No treatment; Group II: 10/mg/kg/day dosage of intraperitoneal (i.p) sildenafil treatment was applied for 72 hours after CLP; Group III: 1/mg/kg/day dosage of i.p milrinone treatment was applied for 72 hours after CLP; Group IV: 150/mg/kg/day dosage of i.p NAS treatment was applied for 72 hours after CLP; Group V: 50/mg/kg/day dosage of i.p pentoxifylline treatment was applied for 72 hours after CLP. All rats were sacrificed on the seventh day of this study. Malondialdehyde (MDA), Glutathione Peroxidase (GPx), Superoxide Dismutase (SOD), catalase, Tumor Necrotic Factor-alpha (TNF-α) levels, and tissue (lung, kidney) and serum samples were taken for histopathological study. Results When compared to the control group, the tissue damage score was found to be lower in all treatment groups. Sildenafil, milrinone and NAS groups had higher kidney GPx levels compared to the control group. Milrinone and pentoxifylline were higher in the lung tissue compared to the SOD control group. TNFα levels were lower in pentoxifylline and milrinone groups compared to the control group. Conclusion This experimental study has shown that PDE inhibitors and NAS have a decreasing effect on oxidative stress and distant organ damage in the two-hit model. Further clinical and experimental studies are needed on this subject.

Purpose To investigate the effects of bradykinin on reperfusion injury in an experimental intestinal ischemia reperfusion model. Methods We used 32 Wistar-Albino rats. We composed 4 groups each containing 8 rats. Rats in sham group were sacrified at 100 minutes observation after laparotomy. Thirty minutes reperfusion was performed following 50 minutes ischaemia in control group after observing 20 minutes. Ischaemic preconditioning was performed in one group of the study. We performed the other study group pharmacologic preconditioning by infusional administration of 10 μg/kg/minute bradykinin intravenously. We sacrified all of the rats by taking blood samples to evaluate the lactate and lactate dehydrogenase (LDH) after resection of jejunum for detecting tissue myeloperoxidase (MPO) activity. Results Lactate and LDH levels were significantly higher in control and study groups than the sham group (P0.05). The results were the same for MPO levels. Although definitive cell damage was determinated in the control group by hystopatological evaluation, the damage in the study groups observed was lower in different levels. However, there was no significant difference between the study groups statistically (P>0.05). Conclusion Either ischeamic preconditioning or pharmacologic preconditioning made by bradykinin reduced the ischemia reperfusion injury at jejunum.

Objective: The debate on the value of laboratory tests in the diagnosis of acute appendicitis (AA) continues. In this study, we aimed to evaluate the blood count parameters and the diagnostic value of neutrophil/lymphocyte ratio in the diagnosis of acute appendicitis.

Decitabine (5-aza-2p-deoxycytidine) is a hypomethylation agent with a double-action mechanism, these are the reactivation of silenced genes; exhibiting differentiation at low doses and showing cytotoxicity at high doses. Decitabine was used as a classic anticancer drug in the original studies in the 1980s, 1500 to 2500 mg/m2 per cycle was the maximum clinically tolerated dose. The dosage was reassessed after a better understanding of epigenetics in cancer and the role of decitabine in epigenetic (hypomethylation) therapy was obtained, in about 1/20th of the previous doses (i.e., 'optimal biological' doses modulating hypomethylation). It has been found that decitabine (100 to 150 mg / m2 per cycle) can be used in patients with myelodysplastic syndromes (MDS) and other myeloid tumors, with manageable side effects. Combination therapies which amplify the epigenetic effect of decitabine will most likely improve the patient responses and allow it to be used in the treatment of other malignancies.

Objective: Gastric cancer consists of many histological subtypes. Prognostic value of histological types in gastric cancer has not been very well defined. In this study, we aimed to investigate the relationship between different histological types and clinicopathologic features and prognosis in gastric cancer.

Purpose: retrorectal tumors [RTs] are a rare incidence and recommendations on the ideal surgical approaches are lacking. This study aimed to evaluate outcomes and follow-up results of patients undergoing excision of RTs at our institution. Methods: a retrospective review was conducted for undergoing surgery for RT between January 2009 and January 2019. Demographic characteristics, presenting symptoms, preoperative diagnostic tests, surgical procedures, histopathological results, intraoperative and postoperative complications, postoperative hospital stay, postoperative 30-day mortality, 90-day unplanned readmission rate, and long-term outcomes were evaluated. Results: twenty patients with a mean age of 48.3 +/- 14.2 were analyzed. The most common presenting complaint was perineal pain (35.0%). Magnetic resonance imaging and computed tomography was preferred in 18 and 2 patients, respectively. Tumor localization was below the level of the third sacral vertebrae in 14 patients for whom the posterior surgical approach was used. No postoperative mortality was recorded at the end of follow-up of 53.8 +/- 40 months. Mean length of postoperative hospital stay was 8.6 +/- 9.4 days. Ten percent of the patients had unplanned hospital readmission within 90 days after discharge. Recurrence developed in 1 patient, for whom pathology were reported as chordoma. conclusion: RT should be managed by a multidisciplinary team given the complexity and heterogeneity of these tumors despite the fact that the majority are benign. A good understanding of pelvic anatomy and characterization of lesions through detailed radiological imaging is crucial to optimize surgical planning. Complete surgical resection is key for prolonged disease-free and overall survival of patients diagnosed with RTs., NA

Objective: The most common cause of acute abdomen requiring surgical intervention globally is acute appendicitis (AA). In this study, we aimed to investigate how AA diagnosis is affected by seasonal changes in Central Anatolia. Materials and Methods: In this study, patients who underwent appendectomy with the diagnosis of (AA) between January 1, 2015 and January 1,2019 were evaluated retrospectively. We divided the patients into three groups based on their histopathological results: Group 1 Acute Appendicitis (AA), Group 2 Appendix vermiformis (AV) and Group 3 Perforated appendicitis (PA). Patients were evaluated concerning age, sex and season of operation. Results: Seven hundred ninety-five patients participated in our study. They were separated into the following groups: Group 1 (n=614), Group 2 (n=125), and Group 3 (n=56). Concerning the sex variable, no statistically significant differences were found between the groups (p=0.061). The mean age of the patients in the perforated appendicitis group was higher when compared to the other groups (p=0.001). When evaluated by season, it was seen that during winter, the patients in Group 1 were significantly higher than the patients in the other groups (p=0.009). In our study, acute appendicitis was most frequently diagnosed during winter (28.7%); appendix vermiformis was most frequently diagnosed during spring (32%) and perforated appendicitis was most frequently diagnosed during summer (41%). Conclusion: Although the diagnosis of acute appendicitis varies seasonally, age and seasonal changes may be effective in the frequency of acute appendicitis. In Central Anatolia, the incidence of acute appendicitis increased during winter, while the rate of perforated appendicitis increased in summer and the rate of negative appendectomy increased in spring.

In this study, we have shown that fluxgate sensors can be used for different application areas. Alternative sensor configurations have been developed for three different application areas. These are mainly rod- and ring-type fluxgate sensors. In the first study, a measurement system with the rod-type fluxgate sensor has been developed in order to monitor the local magnetic field distributions on a magnetic tape (e.g., credit card). With this system, the magnetic recording data on the credit card were measured and imaged successfully. The second and the third application areas, which are monitoring the influence of solar storms on the earth field and heartbeat analysis of mankind, were carried out by using a ring-core fluxgate sensor geometry.

Highlights • Biliary plastic stent placements are commonly performed to treat a variety of biliary disorders. This procedure presents short-term complications such as hemorrhage, pancreatitis, cholangitis, and perforation, in addition to long-term complications such as stent migration and late perforation., Introduction Meckel’s diverticulum is the most common congenital lesion of the small intestine. The incidence varies between 0.5% and 2% Biliary stents can be used for the treatment of patients with bile duct complications. Intestinal perforation due migrated stents is a very rare and life threatening complication. “Perforation of the Meckel diverticulum due to stent”, and no case was found in the literature. For this reason, our case has been identified as the first case seen in the literature. Case presentation A 20 year old male patient liver transplantation was performed from a live donor. 3 years ago The patient presented at our clinic with abdominal pain, nausea and vomiting that has been present for 2 days. Abdominal computed tomography showed a foreign body in the small intestines Patient was operated in emergency conditions. Meckel Diverticulum 40 cm proximal to the ileocecal valve and a biliary drainage catheter perforating the diverticule was seen Meckel's diverticulum was excised, primary repair was performed, Postoperative recovery was uneventful. Discussion Complication rates due to a biliary stent range between 8–10% with a mortality below 1% (Konstantinidis et al. [1]). The most feared complication due to a biliary stent is stent migration. The perforation rate due to stent migration is below 1%. It most commonly occurs in the duodenum. Patients with stent related perforations are surgically managed as other GIS perforations. Conclusions Perforation due to stent migration should also be considered in differential diagnosis in patients with a biliary stent and Acute Abdomen.

WOS: 000485707300017 Although traumatic diaphragmatic ruptures are rare, it is a critical condition that can cause life-threatening complications. Traumatic diaphragmatic rupture may be discovered years after the presentation of the injury, with gastrointestinal or pulmonary symptoms due to a diaphragmatic hernia. Intestinal obstruction due to an isolated diaphragmatic rupture that emerges after a penetrating trauma is highly rare. The present study presents the case of a male patient who underwent laparotomy for intestinal obstruction due to a diaphragmatic hernia caused by a sharp object-induced injury to the thorax 1 year prior to his presentation. We believe that diaphragmatic ruptures are one of the reasons of mechanical intestinal obstruction and that they require urgent surgery.

Acute appendicitis is the most common non-traumatic emergency surgical pathology, and duplication of the appendix is a rare congenital anomaly usually detected incidentally during laparotomy. Since Picoli first described appendix duplex in a female patient who presented with associated anomalies, few other cases have been reported. In this study, we aimed to present a case of appendix duplication detected in a 56-year-old female renal transplant patient undergoing surgery for acute appendicitis. Surgical management of double appendix is of practical importance to avoid serious medical and legal consequences.

The adrenal gland is a common site for metastatic disease. However, isolated adrenal metastases (AM) are rare. We present a case of a rapidly enlarging adrenal mass with solitary distant metastasis from primary malignant melanoma. To our knowledge, the present case is the largest solitary mass that involves the adrenal gland from malignant melanoma in the literature. The present patient with a large adrenal mass (14 cm) was successfully operated by a transperitoneal laparoscopic approach. The surgeon's laparoscopic experience is more important than the lesion size for laparoscopic indications in selected patients.

OBJECTIVE: There are multiple subtypes of breast cancer with different biological and pathological features and accordingly exhibit different clinical behaviors. The aim of this study was to compare the treatment modalities, clinical features and prognostic characteristics of Mix Mucinous Carcinomas (MMBC) and other rare tumors of the breast. MATERIALS AND METHOD: A total of 2152 patients who were operated on for breast cancer in our clinic between 2010–2019, with pathological diagnoses of tubular, pure mucinous, mix mucinous or papillary carcinoma were enrolled in the study. Patients were divided into two groups as mix mucinous patients (Group1) and other rare tumors (Group2). The demographic, clinical and prognostic characteristics and treatment approaches were compared between Groups, and additionally between the subtypes of Group 2. RESULTS: 42 patients participated in our study. Group 1 consisted of 7 patients, and Group2 consisted of 35 patients. The subtypes in Group2 were papillary (n=21), pure mucinous (n=10) and tubular (n=4). Progesterone Receptor Positivity was found to be significantly higher in Group 2 patients than in Group1 patients (p=0.005, p0.05). Mean survival was 19.5+5.6 (8.5–30.5) months in Group 1 and 46.3+5.2 (36.1–56.6) months, in Group2 when evaluated separately (p:0.002). CONCLUSION: The prognosis of pure mucinosis (PMBC) and other atypical cancers of the breast compared to the (MMBC) is quite good. Rare pathological types of breast cancer can have favorable outcomes when treated with necessary oncological principles.

Background: Our aim was to investigate the pathologies in the hernia sac in adults, and the frequency of malignancy as well as to confirm the necessity of maintaining the current applications in histological examination of the hernia sac. Methods: Patients who were operated for hernia in our clinic from 2013 to 2019 were included in the study. Patient data were evaluated retrospectively. We divided the patients into four groups, according to the type of hernia. We evaluated the demographic characteristics of the patients, the pathologies within the hernia sac, histopathological examination outcomes of the hernia sac and clinical features of malignancy in patients with malignancy. Results: A total number of 556 adult patients underwent inguinal, femoral, umbilical or incisional hernia repair in our hospital. Nine patients (0.61%) had malignancy in the hernia sac. Three out of nine patients (33%) had no preoperative diagnosis of malignancy. Six patients (67%) had a known history of malignancy. Two tumors were located in the inguinal (22.0%), six tumors in the incisional (67%), and one in the umbilical (11%) hernia sacs. Among these, 56% were of gastrointestinal, 22% of gynecological, 11% of breast and 11% of epididymis origin. Most of the other pathologies found in the hernia sac were herniated bowel segments, lipomas and omentum. Conclusion: Since the hernia sac might be the first clue for an underlying cancer, if abnormal pathological findings are detected during surgery, histopathological examination should be performed to exclude malignancy. The purpose of histological examination is to detect a hidden malignancy

Amaç: Bu çalışmada, 9 yıl içerisinde adrenal kitle nedeni ile ameliyat edilen olgularda konvansiyonel ve laparoskopik adrenalektominin sonuçlarının karşılaştırılması amaçlanmıştır.Gereç ve Yöntem: Adrenalektomi uygulanan 81 hasta çalışmaya dahil edildi. Grup 1 konvansiyonel, Grup 2 Laparaskopik cerrahi olarak hastalar iki grupa ayrıldı. İki grup, yaş, cinsiyet, vücut kitle indeksi (VKİ), Amerikan anestezistler derneği skoru (ASA), kitle lokalizasyonu, kitle büyüklüğü ve kitlenin hormonal aktivitesi, operasyon süresi, operasyonda kanama miktarı, yatış süresi, gıdaya başlama süresi, perioperatif mortalite, erken dönem komplikasyonlar ve 90 gün içinde hastaneye tekrar başvuru gibi özellikleri esas alınarak retrospektif olarak karşılaştırıldı. Bulgular: Grup 1’de 22, Grup 2’de 59 hasta mevcut idi. Gruplar arasında yaş, cinsiyet, VKİ, ASA skoru, tümör lokalizasyonu, operasyon endikasyonları, postoperatif komplikasyon, perioperatif mortalite ve 90 gün içinde tekrar başvuru açısından istatistiksel olarak anlamlı fark saptanmadı. Kitlenin hormonal aktivitesi Grup 2’de daha yüksek, boyutu ise daha küçük saptandı. Operasyon süresi (dak), ameliyatta kanama miktarı (ml), oral alım süresi (gün) ve hastanede yatış süresi (gün) Grup 1’de daha fazla ve istatiksel olarak anlamlı bulundu. Sonuç: Laparoskopik adrenalektomi uygun hastalarda, kısa operasyon süresi, az kan kaybı, oral gıdaya erken başlama süresi ve daha kısa hastanede kalış süresi gibi avantajları, ayrıca güvenli olması nedeni ile tercih edilmesi gereken cerrahi yöntem olmalıdır., Purpose: The aim of this study was to compare the results of conventional and laparoscopic adrenalectomy in adrenal mass cases operated on during a 9-year period.Materials and Methods: A total of 81 patients who underwent adrenalectomy were included in the study. Patients were divided into two groups as; Group 1 - conventional surgery and Group 2 - laparoscopic surgery. Two groups were compared retrospectively on characteristics such as; age, sex, body mass index (BMI), American Society of Anesthesiologists' score (ASA), mass localization, mass size and hormonal activity of the mass, duration of operation, amount of bleeding in operation, duration of hospitalization, duration until food intake, perioperative mortality, early complications and readmission to hospital within 90 days. Results: There were 22 patients in Group 1 and 59 patients in Group 2. No statistically significant difference was found between the groups in terms of age, sex, BMI, ASA score, tumor localization, indications for operation, postoperative complication, perioperative mortality and re-admittance within 90 days. The hormonal activity of the mass was higher and the mass was smaller in size in Group 2. The duration of operation (min), the amount of bleeding in the operation (ml), the duration until oral intake (days) and the length of hospital stay (days) were found to be statistically significantly higher in Group 1.Conclusion: Laparoscopic adrenalectomy should be the preferred surgical method because of its short duration of operation, low blood loss, early onset of oral food intake and shorter hospital stay, as well as its safety.

In this study, we designed a current sensor based on fluxgate principle. It consists of two coils wound around toroidal ring core from amorphous cobalt-based Metglass 2714A ribbon. Good linearity between the magnitude of measured DC current and the value of second harmonic (2f) voltage induced by the pick-up coil has been observed. Noise level of 46 µA/√Hz at 1 Hz and scale factor of 149 mV/A have been achieved in the developed sensor configuration under specific excitation conditions.In this study, we designed a current sensor based on fluxgate principle. It consists of two coils wound around toroidal ring core from amorphous cobalt-based Metglass 2714A ribbon. Good linearity between the magnitude of measured DC current and the value of second harmonic (2f) voltage induced by the pick-up coil has been observed. Noise level of 46 µA/√Hz at 1 Hz and scale factor of 149 mV/A have been achieved in the developed sensor configuration under specific excitation conditions.

WOS: 000485683800007 Objective: Formation of gallbladder stone is frequently observed after resection for gastric cancer. Extended lymph dissection is shown to be among risk factors. Materials and Methods: We compared patients with limited lymphatic dissection (D1) and extended lymphatic dissection (D2) in terms of gallstone formation and complications. Results: We observed gallbladder stone formation in 13 (12.8%) patients. Gallbladder stone formation was observed in 11.1% of patients in the D1 group and in 14.3% of patients in the D2 group, but no statistically significant difference was found between lymphatic dissections. Of 13 patients, 5 (38.4%) were symptomatic and 3 (23.1%) developed choledocholithiasis. Five patients who were symptomatic were operated without any problems. The groups did not show a statistically significant difference in terms of cumulative survival times. While patients who underwent D2 dissection had more formed gallbladder stone, there were no significant differences between the groups. Conclusion: The complications related to gallbladder stone developed after gastrectomy can be safely managed.

Highlights • Physicians treating this heterogeneous disease need to know the complex underlying mechanisms as well as the multiple management options. • Operative approach is still the definitive treatment and can be preferred to improve patients’ quality of life and to prevent more severe symptoms from developing. • Rare and difficult diagnosis of jejunal diverticulum perforation in elderly patients presenting with acute abdomen should be considered in the differential diagnosis., Introduction Jejunal diverticulosis is a rare intestinal pathology with an incidence of 0.5–1%. While most cases are asymptomatic, 30–40% of the cases may become symptomatic with chronic abdominal pain, malabsorption, hemorrhage, diverticulitis, obstruction, abscess formation and, rarely, diverticula perforation. It is generally localized on the mesenteric side and it develops from the entry points of the vessels into the jejunum. Case presentation Case 1 – A 36-year Case 2 a 75 old female patient patient was admitted to the emergency department with the complaint of widespread abdominal pain, Case 1 8 diverticules, one with diverticule perforation, was observed in the jejunum segment between the 50th and 90th centimeters after the Treitz Ligament. Case 2 – In the diverticulum 100 cm distal from the Treitz ligament, mesenteric perforation area of 4–5 mm were observed. Results Segmentary small bowel resection and side-by-side anastomosis were performed in these cases. In the histopathological examination, the Diverticula were seen to be pseudodiverticullar lesions including herniation of the mucosa and submucosa. Conclusion Jejunoileal diverticulosis is a rare disease with life-threatening complications such as perforation, obstruction and bleeding, it is usually asymptomatic or presents with nonspecific symptoms. It should be considered in the differential diagnosis of acute abdomen.

Background: Bleeding in the biopsy tract has been studied for its ability to decrease the risk of pneumothorax with indefinite results in the previous studies. Purpose: To investigate the risk factors for needle-tract bleeding (NTB) and the possible effect of NTB on the pneumothorax and resultant chest tube placement after CT-guided cutting needle biopsy (CT-CNB) of pulmonary lesions. Methods: Predictive variables for NTB and the effect of NTB on the development of pneumothorax and consequent chest tube placement were retrospectively determined in 416 patients who had undergone an 18-gauge non-coaxial CT-CNB (338 men and 78 women; average age, 59.3 years). Patient-related parameters were age, gender, patient position, and severity of pulmonary emphysema. Lesion-related variables were size, localization, and contour characteristics of the lesion. Procedure-related variables were the presence of atelectasis, pleural tag, and fissure in the needle-tract, length of the aerated lung parenchyma crossed by needle, needle entry angle, number of pleural punctures, the experience of the operator, and procedure duration. All variables were analyzed by x2 test and logistic regression analysis. Results: NTB was demonstrated in 142 of 421 (33.7%) procedures. The predictive variables of NTB were smaller lesion size (p = 0.011) and greater lesion depth (p = 0.002). In patients without emphysema around the lesion, the pneumothorax developed in 44/190 cases (23.1%) without NTB and in 12/95 procedures (12.6%) with NTB (p < 0.001). Conclusion: NTB may have a preventive effect on pneumothorax development, particularly in the absence of emphysema around the lesion.

Aim: In this study,we aim to present the clinical features of patients with Rectus Sheath Hematoma (RSH), therapeutic management and results. Methods: The study included patients who were diagnosed with and received treatment due to spontaneous rectus sheath hematoma between the years 2010 and 2020. The demographic and clinical features of the patients,history of anticoagulant drug use and indication for anticoagulant drugs, laboratory parameters and radiological findings at the time of admission to the hospital, diameter of the hematoma, treatment modalities, follow-up parameters were analyzed retrospectively. Results: Our study included fifty-three patients. The median age was 65.7±14,68 years and 63.3% of the patients were over the age of 65 years. Number of female patients was 35. Cases most often had an American Society of Anesthesiologists score of 3 (64.3%). The most frequently used anticoagulant was warfarin (30.1%) and it was most often used due to heart diseases (54.7%).International Normalized Ratio value at the time of admission to the hospital was 1.93+1.18 and the hemoglobin value was 11.2 gr/dl. Average hematoma diameter was 74 mm and the most common stage was Type 1 (75.6%). 90.6% of the patients were followed up conservatively. Average duration of hospital stay being 15.1 days, mortality developed in 8 patients during their hospital stay. Conclusion: Spontaneous RSH should come to mind in elderly female patients who apply to the hospital with acute abdominal pain and are on anticoagulant therapy. Suspecting RSH can render early and true diagnosis possible, thus reducing morbidity and mortality in these patients.

Aim: In our study, we aimed to investigate the effect of BMI on surgical treatments and general outcomes, as well as on the severity of the injury caused by the sharp object. From an anatomical point of view, increased body mass index (BMI) is expected to have a protective effect in limiting organ damage in the case of sharp object injuries. Material and Methods: Data of the patients with penetrating abdominal injuries who applied to the emergency service of the University between January 2015 and January 2020 were analyzed retrospectively. Patients’ ages, genders, body mass indexes (BMIs), needs for surgical intervention, injury severity scores (ISS) and mortality were evaluated. Patients were divided into 2 groups: obese patients (BMI>30; Group1) and non-obese patients (BMI30; Group2). Results: Seventy-eight patients whose data were available were included in the study. Thirty-three of the patients were determined to be obese (Group1) while 45 were determined to be non-obese (Group2). The mean age of the patients in group1 was significantly higher than the patients in group 2 (p=0.011). The mean ISS of the patients in group 1 was 11.03±8.24 while it was 16.93±13.68 in group 2. The ISS was significantly higher in group2 (p=0.031). Alcohol intoxication levels of the patients in Group 2 were significantly higher than Group 1 (p=0.006). A statistically significant difference was not present between the groups in terms of number of past surgical interventions (p=0.627); however, it was determined that 57% of the surgical interventions in Group 1 were performed for diagnostic purposes and that no pathologies were detected in 45% thereof. Discussion: As a result, increased BMI is associated with lower injury severity scores and decreased need for operation in sharp object injuries. Slim patients are more likely to need surgery and be severely injured.

Aim: the purpose of this study is to determine the prognostic value of the preoperative Neutrophil-to-Lymphocyte ratio (NLR) in patients who underwent curative surgical treatment for hepatocellular carcinoma (HCC). Materials and Methods: Patients who underwent curative resection for HCC between 2004 and 2015 were included in the study. Patients were divided into two groups based on the cut-off value: Group 1 (NLR low) and Group 2 (NLR elevated). Demographics and clinical characteristics, tumor characteristics, and mean survival of patients were compared between the groups. Results: 41 patients were included in our study and Group 1 (NLR low) consisted of (n:11) patients; Group 2 (NLR elevated) consisted of (n:30) patients based on a cut-off value of 2.43. The number of males was higher in both groups (90.9% vs 90%, p:0.712). The Child-Plug class A was the most common one in both groups (81.8%vs76.7%, p:0.680). HBV infection was the most common etiological cause (81.8% vs 53.3%, p:0.344). Lesions were predominantly located in the right lobe (63.6% vs 66.7%, p:0.568). The total tumor diameter was similar (6.56 cm vs 8.69 cm, p:0.258). In the multivariate analysis for survival, tumor diameter greater than 5 cm (HR 1.412 95% - Cl0.345-5.780, p:0.018) and NLR higher than 2.43 (HR 0.100 95% -Cl 0.011-0.882, p:0.038) were independent risk factors. Overall survival time was found to be lower in Group 2 compared to Group 1 (171 vs 106 months p:0.033). Disease-free survival rates were similar in the groups (37 vs 43 months, p:0.485). Conclusion: Although the elevated NLR level was found to be a risk factor for decreased overall survival in our study, this was not related to clinicopathological variables.

Aim: In this study, we aimed to investigate the factors related to postoperative mortality after pancreatoduodenectomy in our clinic. Materials and Methods: Patients who underwent pancreatoduodenectomy due to a periampullary region tumor between 2010 and 2019 were included in the study. Mortality that occurred within 30 days after PD was defined as postoperative mortality and groups were formed according to this definition Group 1(Postoperative Mortality) and Group 2(No mortality). The demographic and clinical features, laboratory parameters, and tumor features of the patients were compared between the groups. Risk factors for mortality were analyzed by univariate analysis and multivariate logistic regression analysis. Results: 155 patients participated in our study. We found our postoperative mortality rate as 11.6%. Accordingly, Group 1 consisted of 18 and Group 2 consisted of 137 patients. The sex was similar (p: 0.235). The average age was higher in Group 1 than 2 (71.2 vs 63.7, p:0.013). Tumor localizations were similar in groups (p:0.275). Lymph node positivity was similar in the groups (50% vs 41.6%, p:0.333). The pancreatic fistula was higher in Group 1, but not statistically significant (33% vs 18.2%, p:0.119). Preoperative white blood cell count (9490 mm3 vs 8050 mm3) and neutrophil count (6898 mm3 vs5442 mm3) were higher in Group 1. In multivariate analysis, no parameters were single-handedly risk factors. Conclusion: No factor was found to be effective alone in the development of mortality after pancreaticoduodenectomy. We think that postoperative mortality may decrease by revealing the factors in the preoperative, intraoperative and postoperative periods.

Aim: Although many studies report risk factors for anastomotic leakage after gastrectomy for gastric cancer (GC), there are conflicting results in the literature. In this study, we aimed to identify the risk factors associated with anastomotic leakage after gastrectomy. Material and Methods: Patients who underwent total gastrectomy for gastric cancer in a single center between September 2015 and September 2018 were evaluated retrospectively. The relationship between anastomotic leakage and clinical variables, tumor characteristics and intraoperative characteristics of 18 parameters were analyzed. The relationship between anastomotic leakage and survival was evaluated.Results: A total of 102 patients were included in the study. Anastomotic leakage rate was 9.81% (10/102). A significant relationship was not determined between anastomotic leakage and age >60 (p:0.232), diabetes mellitus (p:0.334), ASA score >3 (p:0.587), albumin 300 (p:0.582), and operation duration >300 min (p:0.176). Multivariate regression analysis, showed female sex (p: 0.05), body mass index (BMI) >30 (p:0.024) and tumor localization (p:0.005) are independent risk factors for anastomotic leakage. There was a significant difference in mean survival between patients with and without anastomotic leakage (13.9 vs 34.9 months, p: 0.006). Conclusion: Anastomotic leakage was associated with female sex, obesity, and tumor location. We also found that anastomotic leakage adversely affects long-term survival. Detecting risk factors after gastrectomy guides us in the management of patients at the risk for anastomotic leakage.

Aim: Cholangiocellular carcinomas are rare bile duct tumors. They are categorized as intrahepatic(iCCA), perihilar(pCCA) or distal(dCCA) cholangiocarcinomas according to their anatomical location. In this study, we aimed to present our clinical experience in patients with cholangiocellular carcinoma. Material and Methods: Patients who underwent curative surgery with the diagnosis of cholangiocellular carcinoma between 2010 and 2019 were retrospectively reviewed. Demographic and clinical characteristics, surgical procedures, tumor characteristics, short- and long-term results and survival of the patients were analyzed.Results: Twentynine patients were included in the study. The mean age of the patients was 63.3(±10.8) years, and 52% of the patients were older than 65 years. Male sex was 79.3%. Percutaneous biliary drainage was performed in 52% of the patients before the operation. Tumor localizations were distal (dCCA) in 12 (41.4%) patients, perihilar (pCCA) in 11 (38%) patients, and intrahepatic (iCCA) in 6 (20.6%) patients. Only biliary resection was performed in 69%, hepatic + biliary resection in 27.6%, and only hepatic resection in 3.4% of the patients. The mean tumor size was 3.08 cm (±1.91), tumor stage was commonly stage II (58.6%) and postoperative complication was seen in 13.8% of the patients. Ninety-day unplanned readmission was observed in 31.3%, postoperative mortality in 6.9%, and recurrence during postoperative follow-up in 24.2% of the patients. The mean survival time was 22.82(±13.72) months. Conclusion: The type of surgical approach to be performed in cholangiocellular carcinoma is related to the localization of the tumor. With the right patient selection, curative surgical treatment can be performed at low morbidity and mortality rates.