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Background/Aim: The aim of this study is to evaluate the diagnostic and therapeutic difficulties of gastric duplication cysts. Methods: A 38-year-old female patient presented with dyspepsia and repeated episodes of epigastric pain. She was operated with the diagnosis of pancreatic pseudocyst according to her US and CT scans, and found to have a gastric duplication cyst. A cyst about 80×80 mm, localized on the posterior wall of the corpus of the stomach close to the fundus, was dissected from the surrounding tissues and partially from the gastric wall. The cyst did not have muscle layer on the common wall with the stomach, so the cystic mucosa was stripped away from the gastric muscle layer. The gastric lumen was not entered. Results: Although gastric duplication cysts do not have specific symptoms and signs, CT, MR and endoscopic ultrasonography may help the preoperative diagnosis, but the diagnosis is usually confirmed at laparotomy. Needle aspiration may cause complications. Conclusion: Because of the complications that may occur after needle aspiration and malignant potential of the tissue, the treatment of these cysts is surgical.

Recurrence of hepatic hydatid disease is still a serious problem in endemic areas like our country. In this study, we present the causes and management of recurrences after surgical therapy of the hepatic hydatid cysts. Hepatic hydatid cyst patients treated surgically and followed afterward at Istanbul University, Cerrahpasa Medical Faculty, Department of General Surgery between January 1998 and January 2003 were evaluated retrospectively. During this period, 172 primary patients with hepatic hydatid disease were attended to at our clinic. Morbidity and mortality rates for this series were 5.8% and 0.58%, respectively. Recurrence rate was 4.65% during the follow-up period of 60.5 months (range, 25-84 months). Primary causes of recurrence were thought to be unnoticed cysts with exophytic development due to inadequate incision and exposition and spreading of the disease during conservative operative interventions. It is concluded that selection of the proper incision allowing complete exposition, and performance of pericystectomy in solitary, peripherally located cysts prevent recurrence.

Background: After partial hepatectomy, liver regeneration occurs with the hepatocyte mass to its almost previous size. Biliary stricture due to hypertrophied liver rotation following partial hepatectomy is uncommon and its management still remains controversial. We encountered extrahepatic biliary stricture due to hypertrophied left lobe rotation in 2 patients who had right hepatic lobectomy for liver trauma. Herein, we present our experience with the modified Longmire procedure for the management of this complication. Results: There were no complications during the early postoperative period in either of the patients. After the Longmire procedure, the first patient was followed for 5 months with some elevation in liver enzymes and the other was followed for 14 months with normal liver function tests. Both of the patients are completely symptom free postoperatively. Conclusion: The present experience suggests that the modified Longmire procedure is the most promising surgical approach to the management of biliary stricture due to hypertrophied left lobe rotation after right hepatic lobectomy.