Debate over which biopsy needle is the best has intensified recently with the introduction of automated biopsy guns including the 18-gauge long-throw and short-throw Biopty, the 18-gauge Cook, and the 14- and 18-gauge Klear Kut. To evaluate the efficacy of these mechanized biopsy guns versus that of conventional manual biopsy needles in the acquisition of adequate tissue for histopathologic evaluation, open hepatic and renal biopsies were performed in 15 pygmy pigs. The specimens were evaluated separately in a double-blind fashion by two histopathologists using graded criteria. Overall, the best results were obtained with the manual 14-gauge Tru-Cut needle, the long-throw 18-gauge Biopty gun, and the 18-gauge Cook biopsy gun. By comparison, the aspiration-type needles did not perform as well when considered as a group. Several other needles scored well in the biopsy of either the liver or kidney, but not in both. Disappointing results were obtained with the Klear Kut guns (both 14- and 18-gauge) and the Vacu Cut and PercuCut needles.

Backgrounds/Aims: This study was done with the aim of assessing impact of surgery for chronic pancreatitis on exocrine and endocrine functions, quality of life and pain relief of patients. Methods: 35 patients of chronic pancreatitis who underwent surgery were included. Exocrine function assessed with fecal fat globule estimation and endocrine function assessed with glycated haemoglobin (HbA1C), fasting plasma glucose (FPG), Insulin and C-peptide levels. Percentage (%) beta cell function by homeostatic model assessment (HOMA) was determined using web-based calculator. Quality of life (QOL) and pain assessment was done using Short form survey (SF-36) questionnaire and Izbicki scores respectively. Follow up done till 3 months following surgery. Results: Endocrine insufficiency was noted in 13 (37%) patients in the postoperative period compared to 17 (49%) patients preoperatively (p=0.74). Exocrine insufficiency was detected in 11 (32%) patients postoperatively compared to 8 (23%) patients preoperatively, with denovo insufficiency noted in 3 (8%) patients (p＜0.05). The mean Izbicki score at 3 months postoperatively was remarkably lower compared to preoperative score (29.3±14.3 vs. 60.6±12.06; p＜0.05). QOL at 3 months following surgery for chronic pancreatitis was significantly better than preoperative QOL (50.24±22.16 vs. 69.48±20.81; p＜0.05). Conclusions: Significant pain relief and improvement in quality of life among patients of chronic pancreatitis following surgery. However, worsening of exocrine function with only clinical improvement of endocrine function was also noted.

No abstract

Backgrounds/Aims: Pancreaticoduodenectomy (PD) is commonly performed pancreatic procedure for tumors of periampullary region. Delayed gastric emptying (DGE) and pancreatic fistula are the most common specific complications following PD. DGE can lead to significant morbidity, resulting in prolonged hospital stay and increased cost. Various factors might influence the occurrence of DGE. We hypothesized that kinking of jejunal limb could be a cause of DGE post PD. Methods: Antecolic (AC) and retrocolic (RC) side-to-side gastrojejunostomy (GJ) groups in classical PD were compared for the occurrence of DGE in a prospective study. All patients who underwent PD between April 2019 and September 2020 in a tertiary care center in south India were included in this study. Results: After classic PD, RC GJ was found to be superior to AC in terms of DGE rate (26.7% vs. 71.9%) and hospital stay (9 days vs. 11 days). Conclusions: Route of reconstruction of GJ can influence the occurrence of DGE as RC anastomosis in classical PD provides the most straight route for gastric emptying.

INTRODUCTION: Extraintestinal GIST (EGIST) is a rare mesenchymal tumor. There is lack of sufficient literature regarding EGISTs. We have undertaken a retrospective observational study to analyze the epidemiology, clinicopathological features and outcomes of EGISTs. METHODS: All patients with the diagnosis of EGIST in the department of Surgical Gastroenterology, SVIMS from January 2015 to December 2019 were included. Patient’s demographics, laboratory and imaging findings, intra-operative findings, tumor pathology and outcomes were analyzed. RESULTS: Fourteen patients were included. Of these, 8 (57.14%) were males. Mean age was 53.43 years. Most patients (85.71%) presented with abdominal pain. Most common site of EGIST was retroperitoneum (50%). Preoperative imaging was diagnostic of GIST of gastro-intestinal origin in all patients. 71.43% tumors were >10cm in size and 50% had >10 mitotic index. Twelve patients underwent radical surgery. All were advised adjuvant therapy. Mean hospital stay was 7.07 days. Median survival was 38.5 months (range 4-60 months). CONCLUSION: EGISTs are more likely to be malignant, large in size, with high mitotic rates. Imaging may not be accurate for diagnosis. Owing to low incidence of EGISTs, multi-center studies are required to study their clinical and pathological behavior.