Adrian Bartos

By Adrian Bartoș, Andrei Herdean and Dana Monica Bartoș

Gallbladder cancer represents one of the rare and highly fatal neoplastic diseases, early diagnosis and treatment being the key for an acceptable outcome. The best survival results are obtained for patients with T1-T2 stage, a radical cholecystectomy being sufficient in most of these cases. For advanced tumors, major liver resections could be necessary to obtain optimal oncological results. Although a high percentage of the patients are diagnosed with unresectable disease, the continuous progresses made in the field of surgical therapy and oncological treatment could finally improve the outcome of this neoplastic pathology.

Part of the book: Updates in Gallbladder Diseases

By Lucian Mocan, Ofelia Mosteanu, Teodora Pop, Lucia Agoston- Coldea, Cornel Iancu, Teodora Mocan and Furcea Luminita

There are about 500,000 new cases of cancer of the esophagus and 400,000 esophageal cancer-related deaths recorded annually around the world. The disease is three to four times more frequent in men than in women, being the sixth most common cancer and the fifth most frequent cancer-related death among men. The prognosis of esophageal cancer is quite poor, despite advances in surgical procedures (two-field and three-field lymph node dissection) and perioperative management, which is still controversial. The use of chemotherapy and radiotherapy in combination with surgery might be a new approach for future treatment. Progress in optical technology has led to the development of a new minimally invasive surgical approach for the treatment of esophageal cancer, namely esophagectomy.

Part of the book: Esophageal Abnormalities

By Adrian Bartoș, Ioana Iancu, Caius Breazu and Dana Bartoș

Intraoperative liver ultrasound represents an essential component in the hepatobiliary surgery arsenal, having an essential role in describing liver lesions, their topography, and loco-regional extension. It also has an important role in establishing surgical strategy, in modulating the surgeon decisions, and thus in preventing postoperative complications. This chapter tries to make a synthetic review of principal indications for using ultrasound in liver surgical treatment, underlining the liver’s lesions characteristics and advantages brought by this method. Also, we wanted to underline the importance that ultrasound has for guiding the surgeon in interventional intraoperative techniques or in any anatomical liver resection. The role of enhanced contrast intraoperative ultrasound is put in front by the better diagnostic results obtained for both primary and metastatic tumors of the liver.

Part of the book: Liver Research and Clinical Management

By Adrian Bartoș, Cristian Cioltean, Caius Breazu and Dana Bartoș

Hepatocellular carcinoma (HCC) is the most frequent primary malignant tumor of the liver, being the sixth most common cancer in the world and the third cause of cancer mortality. Most of the patients with HCC have an established background of cirrhosis and chronic liver disease. Magnetic resonance imaging (MRI) is the best technique for evaluation of the liver nodules in patients with cirrhosis, especially when a HCC is suspected. HCC staging is mandatory to select the appropriate primary and adjuvant therapy and to evaluate the prognosis. Hepatic resection is the treatment of choice in non-cirrhotic patients who have been diagnosed with HCC. In this chapter we underline the main diagnostic methods used for HCC staging, together with the treatment possibilities, highlighting the importance of surgical management, conventional or minimally invasive.

Part of the book: Liver Research and Clinical Management

By Caius Mihai Breazu, Adrian Bartos and Dana Bartos

Bartter and Gitelman syndromes are rare genetic disorders in which there are specific defects in kidney function, characterized by metabolic alkalosis, hypokalemia, hyperreninemia, and hyperaldosteronism, with or without hypomagnesemia. Blood pressure is normal or low in these patients. Positive diagnosis is one of the exclusions, and the difference between the two syndromes is based on urine calcium levels. Medication has to be taken lifelong. Renal transplantation can correct the transport defect in Bartter and Gitelman syndromes. The symptoms and severity vary from one person to another and can range from mild to severe. Age of onset of overt symptoms can range from before birth to adulthood.

Part of the book: Fluid and Electrolyte Disorders

By Adrian Bartos, Andrei Herdean and Dana Monica Bartos

Distal cholangiocarcinoma is a rare malignant condition arising from the epithelial cells of the biliary tract. Surgical resection is the only curable alternative for patients with this disease. True resectability is often determined by surgical exploration. Duodenopancreatectomy is an extremely high-demanding technique and is the only one that can be potentially curable for patients diagnosed with resectable distal cholangiocarcinoma. Long-term survival may be achieved only in selected patients, undergoing duodenopancreatectomy, especially in patients where R0 margins are achieved. Perineural extension, pancreatic invasion, and lymph nodes involvement are the main risk factors for recurrence. Palliative biliodigestive diversion or endoscopic internal drainage of the biliary tree is alternative for patients with unresectable tumors. Although the prognosis after surgical treatment of distal common bile duct malignancy is better than for other periampullary tumors, the continuous progresses made in the field of surgical therapy and oncological treatment may lead to an improvement in the outcome of this neoplastic pathology.

Part of the book: Bile Duct Cancer