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KÖKER, İBRAHİM HAKKI

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İBRAHİM HAKKI
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KÖKER
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Start date: 2020 × End date: 2022 ×

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    ID: 3524972 MUCINOUS PANCREATIC CYST SUBGROUPS: THE ROLE OF CYST FLUID VISCOSITY AND CYST MORPHOLOGY IN DIFFERENTIATION
    (2021-05-21T00:00:00Z) KÖKER, İBRAHİM HAKKI; Elagöz, Şahende; MALYA, FATMA ÜMİT; Kiremitçi, Sercan; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; MALYA, FATMA ÜMİT; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKAN
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    BOUGIE DILATATION IN BENIGN ESOPHAGEAL STRICTURES: EVALUATION OF ADJUVANT METHYLPREDNISOLONE INJECTION
    (2022-05-01T00:00:00Z) KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKAN
    Objective: Mechanical dilatation and adjuvant injection of tri-amcinolone acetate (TA) effectively preserve the opening pro-vided and reduce the number of bougie dilation (BD) in benign esophageal strictures. In this study, we aimed to evaluate the role of Methylprednisolone (MP) injection after BD in providing permanent/long-term lumen opening.
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    The clinical feature and outcome of groove pancreatitis in a cohort: A single center experience with review of the literature
    (2022-08-01T00:00:00Z) DEĞER, KAMURAN CUMHUR; KÖKER, İBRAHİM HAKKI; Destek, Sabahattin; TOPRAK, HÜSEYİN; Yapalak, Yunus; GÖNÜLTAŞ, CEREN; ŞENTÜRK, HAKAN; DEĞER, KAMURAN CUMHUR; KÖKER, İBRAHİM HAKKI; TOPRAK, HÜSEYİN; GÖNÜLTAŞ, CEREN; ŞENTÜRK, HAKAN
    BACKGROUND: Groove pancreatitis (GP) is a rare form of chronic pancreatitis that is less common and is now gaining awareness with multimodal imaging modalities. Our aim is to analyze the mid-long term outcomes of patients diagnosed with GP with different treatment approaches.
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    Pankreas Divisum’un Akut Pankreatit’te Yeri, Takipli Hastalarda Restenoz ve Malignite Gelişenlerin Özellikleri
    (2021-11-21T00:00:00Z) Köker, İbrahim Hakkı; Biberci Keskin, Elmas; Koçhan, Koray; Kiremitçi, Sercan; Değirmencioğlu, Şerife; Seven, Gülseren; İnce, Ali Tüzün; Şentürk, Hakan; KÖKER, İBRAHİM HAKKI; BİBERCİ KESKİN, ELMAS; KOÇHAN, KORAY; KİREMİTÇİ, SERCAN; DEĞİRMENCİOĞLU, ŞERİFE; SEVEN, GÜLSEREN; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKAN
    GİRİŞ: Pankreas divisum (PD) akut pankreatit’le (AP) başvuran hastalarda tanı konulması zor olabilen bir konjenital patolojidir. Amacımız PD’lu hastaların AP’deki sıklıklarını ve takip sonuçlarını değerlendirmekti.METODLAR: Retrospektif olarak AP ile başvuran 524 hastanın 32 (%6.1)’inde kesitsel ve endosonografik olarak PD tanısı koyduk. Pankreas divisum’lu hastaların yaş ve cinsiyet özellikleriyle takipte restenoz ve malignite gelişen hastaların özelliklerini değerlendirdik.BULGULAR: Akut pankreatitle başvuran 524 hastada etyolojik olarak ilk sırada biliyer patolojiler (n=308(58.7), 191(%62) kadın) bulunurken, PD’lu 32 (%6), 18(%56.3) erkek, yaş ortalaması 44.7±15.1 yıl (min-maks 16-75) hastada biliyer etyolojiden anlamlı olarak yaş (p<0.001) ve cinsiyet (p<0.001) farklı saptadık. Hastaların 29’u (%90.6) komplet tipti (17(58.6) erkek). Inkomplet PD’nin 2’si kadın, 1’i erkekti. Hastaların 20’sine (%62.5) tedavi amaçlı wirsung’a minor papilladan plastik stent yerleştirildi. Takipte 4 (%20) hastada stent sonrası minor papilla’da restenoz gelişti. Bunların 3 (%75)’ü erkekti. Restenoz gelişen 4 hastanın yaş ortalaması 44±12.3, (min-maks 28-57) yıldı. Bu hastalardan 1’ine endosonografik wirsungogastrostomi ile wirsung-gastrik duvar arasında fistül oluşturularak wirsung içindeki taşlar temizlendi. Takip esnasında 1 inkomplet (60 yaş), 1 komplet PD’li (44 yaş) 2 erkekten birisinin pankreas baş ve gövdesinde, diğerinin pankreas başında CA 19-9 eksprese etmeyen agresif seyirli pankreatik duktal adeno karsinom saptadık.SONUÇ: Pankreas divisum AP’de düşük oranda ve erkek cinsiyette daha fazla iken, restenoz ve malignite gelişimini de yine erkeklerde daha sık saptadık. Restenoz tedavisinde ise wirsungo-gastrostomik fistül oluşturma yaklaşımı uygun bir seçenek olabilir. Anahtar Kelimeler: akut pankreatit, malignite, pankreas divisum, restenoz
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    CA 19-9 Eksprese Etmeyen Pankreaatik Duktal adenokarsinom Tanılı Hastaların Demografik Özellikleri
    (2021-11-21T00:00:00Z) Köker, İbrahim Hakkı; Yurtsever, İsmail; Şentürk, Hakan; KÖKER, İBRAHİM HAKKI; YURTSEVER, İSMAİL; ŞENTÜRK, HAKAN
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    Müsinöz Pankreas Kist Alt Guruplarında Kist Boyutlarının Ve Kist Sıvı Viskozitesinin Malignite Açısından Belirleyiciliği Var Mıdır ?
    (2021-09-20T00:00:00Z) KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKAN
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    Evaluation of Ki67 index in endoscopic ultrasound-guided fine needle aspiration samples for the assessment of malignancy risk in gastric gastrointestinal stromal tumors.
    (2020-10-05T00:00:00Z) Senturk, Hakan; Seven, GÜLSEREN; Kochan, KORAY; Caglar, Erkan; Kiremitci, Sercan; Koker, Ibrahim Hakki; SEVEN, GÜLSEREN; KOÇHAN, KORAY; KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKAN
    Background: The risk of malignancy in resected gastrointestinal stromal tumors (GISTs) depends on tumor size, location, and mitotic index. Reportedly, the Ki67 index has a prognostic value in resected GISTs. We aimed to analyze the accuracy of endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) samples with reference to Ki67 index, using surgical specimens as the gold standard. Methods: Fifty-five patients who underwent EUS-FNA followed by surgical resection for gastric GISTs were retrospectively analyzed. Patients’ age and sex; tumors’ size and location; mitotic index, cell type, cellularity, pleomorphism, presence of ulceration, hemorrhage, necrosis, mucosal or serosal invasion, growth pattern, and Ki67 index based on pathology were investigated. Results: Location in fundus, ulceration, hemorrhage, mucosal invasion, and Ki67 index in surgical specimens were significant in predicting high-risk groups (P < 0.05) on univariate analysis. resence of bleeding (P = 0.034) and the Ki67 index (P = 0.018) were the only independent significant factors in multivariate analysis. The optimal cutoff level of Ki67 was 5%, with 88.2% sensitivity and 52.8% specificity (P = 0.021). The mean Ki67 index was lower in EUS-FNA samples than in surgical specimens [2% (1-15) vs. 10% (1-70), P = 0.001]. The rank correlation coefficient value of Ki67 was 0.199 (P = 0.362) between EUS-FNA and surgical samples and showed no reliability for EUS-FNA samples. Conclusion: The Ki67 index in resected specimens correlated with high-risk GISTs, although it had no additive value to the current criteria. The Ki67 index in EUS-guided FNA samples is not a reliable marker of proliferation in GISTs.
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    PublicationOpen Access
    Can serum histone H4 levels predict mucosal healing in Crohn-s disease?
    (2021-01-01T00:00:00Z) KÖKER, İBRAHİM HAKKI; SÜMBÜL, BİLGE; KİREMİTÇİ, SERCAN; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; BİBERCİ KESKİN, Elmas; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; SÜMBÜL, BİLGE; KİREMİTÇİ, SERCAN; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; BİBERCİ KESKİN, ELMAS; ŞENTÜRK, HAKAN
    Introduction: Mucosal healing (MH) has been a treatment target with the introduction of biological agents in Crohn's disease (CD). Histone H4 increases in chronic inflammation. Aim: Our goal was to investigate the role of serum histone H4 in predicting MH. Material and methods: The study included 44 patients who applied to the endoscopy unit for ileocolonoscopic evaluation with the diagnosis of ileocecal CD and 26 healthy controls. After ileocolonoscopic evaluation, we divided the patients into 2 groups: those with and those without MH, according to the presence of endoscopic ulcer or erosion findings. Blood samples were taken from these patients to analyse serum histone H4 before the endoscopic procedure. We first compared serum histone H4 levels between CD patients and the healthy control group and then between those with and those without MH among the CD patients. Finally, we compared CRP, ESR, and serum histone H4 levels in patients with CD according to the presence of MH and symptoms. Results: Serum histone H4 levels were significantly higher in ileocolonic CD patients compared to the healthy control group (p = 0.002). Also, serum histone H4 levels were significantly higher in CD patients with no MH (p = 0.028) or symptomatic patients (p = 0.033). We did not find a significant difference in C-reactive protein and erythrocyte sedimentation rate levels between CD patients in the presence of MH (p = 0.281 and p = 0.203, respectively) or symptoms (0.779 and 0.652, respectively). Conclusions: Serum histone H4 might be a useful biomarker for MH prediction in ileocolonoscopic CD patients. Validation is needed for large numbers of patients.
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    Sa1443 CYST FLUID CARCINOEMBRYONIC ANTIGEN DIFFERENCE AMONG MUCINOUS CYSTIC NEOPLASMS AND INTRADUCTAL PAPILLARY MUCINOUS NEOPLASMS
    (2020-05-05T00:00:00Z) KÖKER, İBRAHİM HAKKI; Ünver, Nurcan; MALYA, FATMA ÜMİT; UYSAL, ÖMER; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; MALYA, FATMA ÜMİT; ŞENTÜRK, HAKAN
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    PublicationOpen Access
    Mucinous Pancreatic Cysts: Comparison of Cyst Size and Location in Certain Mucinous Cyst Subgroups
    (2021-09-01T00:00:00Z) KÖKER, İBRAHİM HAKKI; Elagoz, Sahende; GÜCİN, ZÜHAL; MALYA, FATMA ÜMİT; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; GÜCİN, ZÜHAL; MALYA, FATMA ÜMİT; ŞENTÜRK, HAKAN
    Background: There are studies reporting that the location of intraductal papillary mucinous neoplasia (IPMN) predicts malignancy. Therefore, we evaluated the cyst location’s relationship with malignancy, and the possibility of using cyst size and location to distinguish between non-main duct (non-MD)-IPMNs, mucinous cystic neoplasia (MCN), and cystic pancreatic ductal adenocarcinoma (PDAC). Methods: We performed a retrospective analysis of data from 122 patients with a definite cyto-histological diagnosis of non-MDIPMNs, LR-MCNs, and cystic PDACs via endoscopic ultrasound fine-needle aspiration between October 2011 and October 2020. We grouped the cyst locations as head, uncinate, neck (HUN), and corpus or tail (CT). On histology, low-grade dysplasia and intermediategrade dysplasia were considered low risk (LR), whereas high-grade dysplasia and invasive carcinoma were considered high risk (HR). Results: Of the 122 patients (61 (50%) women, median age 61.5 years (range 19-85), there were 34 (27.9%) LR-non-MD-IPMNs, 33 (27%) HR-non-MD-IPMNs, 19 (15.6%) LR-MCNs, and 36 (29.5%) cystic PDACs. We found no significant difference between LRand HR-non-MD-IPMN locations (P = .803). Low-risk non-MD-IPMNs were significantly smaller than HR-non-MD-IPMNs (P < .001), LR-MCNs (P = .002), and cystic PDACs (P < .001). The area under the receiver operating characteristic curve (AUROC) was 0.819 (95% CI: 0.716-0.902; P < .0001), and demonstrated a cyst size cut-off <2.2 cm to differentiate LR cysts, while cysts <1.6 cm had a negative predictive value (NPV) of 100% in non-MD-IPMNs. Conclusion: Cyst location is not predictive of malignancy in non-MD-IPMNs. Low-risk non-MD-IPMNs were smaller than HR-non-MDIPMNs, LR-MCNs, and cystic PDACs. The cyst size cut-off was 2.2 cm; however, <1.6 cm had a 100% NPV differentiating LR- from HR-non-MD-IPMNs