Person: BİBERCİ KESKİN, ELMAS
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Publication Metadata only Sa1359 – Cholecystitis in Pancreatic Carcinoma: A Poorly Recognized Condition with High Rate of Sepsis Related Mortality Cholecystitis in Pancreatic Carcinoma: A Poorly Recognized Condition with High Rate of Sepsis Related Mortality.(2019-05-28T00:00:00Z) Koçhan, Koray; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; BİBERCİ KESKİN, ELMAS; İNCE, ALİ TÜZÜN; BAŞARANOĞLU, METİN; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; KOÇHAN, KORAY; BİBERCİ KESKİN, ELMAS; İNCE, ALİ TÜZÜN; BAŞARANOĞLU, METİNPublication Metadata only Pankreas kistlerinde tersiyer merkez deneyimimiz(2018-10-14T00:00:00Z) koray, koçhan; KÖKER, İBRAHİM HAKKI; BİBERCİ KESKİN, ELMAS; ünver, nurcan; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; BİBERCİ KESKİN, ELMAS; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKANPublication Metadata only Pankreas Kistlerinde müsinöz/nonmüsinöz ayırımında string testin yararı ve aspirat CEA ölçümü ile karşılaştırılması(2017-12-06T00:00:00Z) koçhan, koray; BİBERCİ KESKİN, ELMAS; ünver, nurcan; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; BİBERCİ KESKİN, ELMAS; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKANPublication Metadata only 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, HAKANGİRİŞ: 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, restenozPublication Metadata only Kolesistektominin pankreatit atak sıklığIı ve şiddeti üzerine etkisi(2017-12-06T00:00:00Z) BİBERCİ KESKİN, ELMAS; İNCE, ALİ TÜZÜN; KÖKER, İBRAHİM HAKKI; KOÇHAN, KORAY; BAŞARANOĞLU, METİN; ŞENTÜRK, HAKAN; BİBERCİ KESKİN, ELMAS; İNCE, ALİ TÜZÜN; KÖKER, İBRAHİM HAKKI; KOÇHAN, KORAY; BAŞARANOĞLU, METİN; ŞENTÜRK, HAKANPublication Metadata only CHOLECYSTITIS IN PANCREATIC CARCINOMA: A POORLY RECOGNIZED CONDITION WITH HIGH RATE OF SEPSIS RELATED MORTALITY CHOLECYSTITIS IN PANCREATIC CARCINOMA: A POORLY RECOGNIZED CONDITION WITH HIGH RATE OF SEPSIS RELATED MORTALITY(2019-05-01T00:00:00Z) Senturk, Hakan; Kochan, Koray; Koker, Ibrahim H.; Keskin, Elmas; Ince, ALİ TÜZÜN; Basaranoglu, Metin; ŞENTÜRK, HAKAN; KOÇHAN, KORAY; BİBERCİ KESKİN, ELMAS; İNCE, ALİ TÜZÜNPublication Metadata only EFFECT OF CHOLECYSTECTOMY ON PREVENTING RECURRENCE OF ACUTE PANCREATITIS(2022-10-11) Seven G.; Musayeva G.; İnce A. T.; Biberci Keskin E.; SEVEN, GÜLSEREN; İNCE, ALİ TÜZÜN; BİBERCİ KESKİN, ELMASBackground and AimsCurrent guidelines recommend cholecystectomy in patients with acute biliary pancreatitis (ABP) to prevent recurrence. Some studies suggest that a significant portion of patients with idiopathic acute pancreatitis (IAP) results from occult biliary disease and cholecystectomy, after an episode of IAP, reduces the risk of recurrent pancreatitis. However, in these studies, the work-up for potential biliary cause is not extensive and do not include endoscopic ultrasound (EUS), which can detect a biliary disease up to one-third of patients with IAP. In this study, we aimed to ascertain whether cholecystectomy can prevent pancreatitis recurrence in patients with ABP and IAP.MethodsAdult patients (over 18 years) with first episode of acute pancreatitis (AP) who admitted to inpatient clinic between January 1, 2015 and December 31, 2021 at a tertiary referral center were retrospectively reviewed. Medical records were scrutinized and relevant data extracted. In addition, a questionnaire either by mail or telephone was used. Patients with biliary and idiopathic AP were included in the analysis. Patients with chronic pancreatitis, previous pancreatic surgery, pancreatic cancer, and other etiologies were excluded. Primary outcome was recurrence rate. The diagnosis of IAP was confirmed by exclusion of all known etiological factors for AP using extensive work-up, including EUS and/or magnetic resonance cholangiopancreatography (MRCP).ResultsA total of 500 patients with first episode of AP (300 patients with ABP and 200 patients with IAP) were identified. The mean age was 58 years and 267 women, 233 men. The patients were divided into three different groups: Group 1; patients who had their first pancreatitis attack after cholecystectomy, Group 2; patients who had their gallbladder in situ during the first attack and followed by cholecystectomy and Group 3; patients who had their gallbladder in situ during the first attack but did not have cholecystectomy. The number of patients with recurrence after the first episode of AP were not statistically different in whole study group (25%, 19% and 15%, respectively, P = 0.176). In the subgroup of patients with ABP, the recurrence was higher in group 1 as compared with group 2 and 3 (39%, 19% and 14%, respectively, P = 0.018). On the other hand, in the subgroup of patients with IAP, there was no significant difference among the groups in terms of recurrence (15%, 18%, and 17%, respectively, P = 0.999). When patients with in situ gallbladder during their first attack were compared according to their cholecystectomy history (group 2 vs. group 3), no significant difference was found in neither the ABP nor the IAP subgroups (19% vs 14% and 18% vs. 17%, respectively, P > 0.05). In addition, the effect of endoscopic retrograde cholangiopancreatography (ERCP) on recurrence of pancreatitis was evaluated. In subgroup of ABP, ERCP was effective for reducing the recurrence in group 2 (P = 0.008), while it was not found statistically significant in group 1 and 3. In subgroup of IAP, it ERCP did not reduce the recurrence in any of the groups.ConclusionsIn ABP, the recurrence is high in patients who have their first pancreatitis attack after cholecystectomy. Cholecystectomy alone is not effective preventing recurrence in patients with gallbladder in situ during the first episode; however, the risk can be decreased with adding ERCP to cholecystectomy. On the other hand, cholecystectomy is not effective in reducing the recurrence in patients with IAP.Key Words: Acute biliary pancreatitis; Idiopathic acute pancreatitis; Cholecystectomy.References:1. Crockett SD, Wani S, Gardner TB, et al. American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis. American Gastroenterological Association Institute Clinical Guidelines Committee. Gastroenterology. 2018 Mar;154(4):1096-1101.2. Räty S, Pulkkinen J, Nordback I, et al. Can Laparoscopic Cholecystectomy Prevent Recurrent Idiopathic Acute Pancreatitis?: A Prospective Randomized Multicenter Trial. Ann Surg. 2015 Nov;262(5):736-41.3. D S Umans, N D Hallensleben , R C Verdonk, et al. Recurrence of idiopathic acute pancreatitis after cholecystectomy: systematic review and meta-analysis. Br J Surg 2020 Feb;107(3):191-199.Publication Metadata only Kronik hepatit C nedeniyle direk anti viral alan tedavi hastarda hepatosellüler kanser gelişimi(2018-04-29T00:00:00Z) BİBERCİ KESKİN, ELMAS; İNCE, ALİ TÜZÜN; KOÇHAN, KORAY; KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKAN; BİBERCİ KESKİN, ELMAS; İNCE, ALİ TÜZÜN; KOÇHAN, KORAY; KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKANPublication Metadata only Pankreas kistlerinin değerlendirilmesinde Probe -based confocal laser endomikroskopi tanıya katkıda bulunuyor mu?(2017-12-06T00:00:00Z) ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; BİBERCİ KESKİN, ELMAS; İNCE, ALİ TÜZÜN; ÜNVER, NURCAN; ARICI, DİLEK SEMA; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; BİBERCİ KESKİN, ELMAS; İNCE, ALİ TÜZÜNPublication Metadata only Psödokist olgularının özellikleri ve kistogastrostomi sonuçlarımız: Tersiyer merkez deneyimi(2018-11-25T00:00:00Z) KÖKER, İBRAHİM HAKKI; BİBERCİ KESKİN, ELMAS; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; BİBERCİ KESKİN, ELMAS; KOÇHAN, KORAY; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKAN
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