Suspicion of an SC should lead to performance of a magnetic resonance imaging for defining tumor extent, and a fludeoxyglucose positron emission tomography-CT for detection of metastases. Radical tumor excision and resection of tumor involved regional lymph nodes are essential for a curative approach. Histopathological evaluation should involve determination of tumor differentiation grade, because high-grade carcinomas seem to have a much more aggressive behavior. Excision of distant metastases has no therapeutic value. Follow-up needs to be carried out in short intervals with frequent imaging.

IGBC has a low incidence (0.28%). We present a large study of patients with IGBC, comparing the overall survival by different histological findings. We observed a significant benefit for the group with pT2 and pT3. Therefore we recommend extended resection of the gallbladder bed and the regional lymph nodes for patient with incidental histologically confirmed pT2 and pT3 carcinoma of the gallbladder after performance of laparoscopic cholecystectomy. For patients with pT1b stage no recommendations can be given based on this study.

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Three-dimensional fracture networks, combined from seismic scale to wellbore scale, can greatly enhance the knowledge of fracture contribution to hydrocarbon storage and flow inside the reservoir. This paper presents some techniques used at ENI-Agip for fracture network simulation at wellbore scale. First, new imaging techniques adopted for enhancing and facilitating the data acquisition from orientated cores will be shown. We will discuss how the fracture data, acquired from the combined analysis of orientated core and wellbore image logs, have to be processed in order to calculate the geometrical parameters of each feature (dip direction, dip, size, terminations) and to classify them according to their filling (oil, water, shale, calcite, etc.). Second, we will illustrate how these kind of data are processed in order to extract the fracture representative parameters needed for stochastic simulation of fracture network at the wellbore scale: spatial distribution along the cored/logged interval, number of fracture sets, representative orientation and statistical distribution of each set, distribution laws of the fracture length and relevant minimum radii and fracture aperture estimate. Fracture porosity evaluation, matrix block size, fracture network connectivity at wellbore scale constitute the outputs of such simulations: they are used to better characterize a fractured reservoir and to describe its behaviour. The synthetic results of the application of such a methodology on a real case (tight packstone/wackestone of carbonate platform from a southern Apennine italian oil reservoir) complete the paper.The main target of the reservoir geologist is the petrophysical characterization of the reservoir in order to estimate: 9 the original hydrocarbons in place; 9 the fluid flow path; and thus 9 the reserves.The building of a geological model, which reasonably describes the lateral and vertical variations of the petrophysical characteristics, i.e. porosity, permeability and hydrocarbon saturation, stands at the root of these estimates. The hydrocarbons in place are, in fact, estimated on the basis of this geological model, and very often a three-dimensional (3D) numerical model, which schematically represents the geological reality, is built in order to estimate the reserves.The petrophysical characterization of fractured reservoirs is more complicated than conventional non-fractured reservoirs because of the presence of two different pore systems: the matrix pore system and the fault-fracture network pore systemThe recognition of the presence of a fracture network is, therefore, crucial because it has a significant effect on reservoir fluid flow. Considering values of fracture porosity that become progressively more significant when compared to the matrix porosity, there are four ways in which fractures can affect a reservoir. Schematically, four types of reservoir can be recognized according to the different contribution of fractures: type 1: type 2: type 3: type 4: fractures impart no positive reservoir quality bu...

AIMTo evaluate upper abdominal computed tomography (CT) scan as primary follow-up after laparoscopic Roux-en-Y gastric bypass (LRYGB).METHODSThis prospective study was approved by the Ethical Committee of the State of Zurich, and informed consent was obtained from all patients. Sixty-one patients who underwent LRYGB received upper abdominal CT on postoperative day 1, with the following scan parameters: 0.6 mm collimation, 1.2 mm pitch, CareKV with reference 120 mAs and 120 kV, and 0.5 s rotation time. Diluted water-soluble radiographic contrast-medium (50 mL) was administered to achieve gastric pouch distension without movement of the patient. 3D images were evaluated to assess postoperative complications and the radiation dose received was analysed.RESULTSFrom the 70 patients initially enrolled in the study, 9 were excluded from analysis upon the intraoperative decision to perform a sleeve gastrectomy and not a LRYGB. In all of the 61 patients who were included in the analysis, CT was feasible and there were no instances of aspiration or vomiting. In 7 patients, two upper abdominal scans were necessary as the pouch was not distended by contrast medium in the first acquisition. Radiologically, no leak and no relevant stenosis were found on the first postoperative day. These early postoperative CT findings were consistent with the findings at clinical follow-up 6 wk postoperatively, with no leaks, stenosis or obstructions being diagnosed. The average total dose length product in CT was 536.6 mGycm resulting in an average effective dose of 7.8 mSv. The most common surgical complication, superficial surgical site infections (n = 4), always occurred at the upper left trocar site, where the circular stapler had been introduced.CONCLUSIONEarly LRYGB postoperative multislice spiral CT scan is feasible, with low morbidity, and provides more accurate anatomical information than standard upper gastrointestinal contrast study.