The excision of the head of the pancreas and the encircling loop of the duodenum to which it is connected.
Abnormal passage communicating with the PANCREAS.
Surgical anastomosis of the pancreatic duct, or the divided end of the transected pancreas, with the jejunum. (Dorland, 28th ed)
A dilation of the duodenal papilla that is the opening of the juncture of the COMMON BILE DUCT and the MAIN PANCREATIC DUCT, also known as the hepatopancreatic ampulla.
Tumor or cancer of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
Tumors or cancer of the PANCREAS. Depending on the types of ISLET CELLS present in the tumors, various hormones can be secreted: GLUCAGON from PANCREATIC ALPHA CELLS; INSULIN from PANCREATIC BETA CELLS; and SOMATOSTATIN from the SOMATOSTATIN-SECRETING CELLS. Most are malignant except the insulin-producing tumors (INSULINOMA).
Tumors or cancer of the DUODENUM.
Surgical removal of the pancreas. (Dorland, 28th ed)
Pathological processes of the PANCREAS.
The region of the STOMACH at the junction with the DUODENUM. It is marked by the thickening of circular muscle layers forming the pyloric sphincter to control the opening and closure of the lumen.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Carcinoma that arises from the PANCREATIC DUCTS. It accounts for the majority of cancers derived from the PANCREAS.
Chronic delayed gastric emptying. Gastroparesis may be caused by motor dysfunction or paralysis of STOMACH muscles or may be associated with other systemic diseases such as DIABETES MELLITUS.
Surgical formation of an opening through the ABDOMINAL WALL into the JEJUNUM, usually for enteral hyperalimentation.
Ducts that collect PANCREATIC JUICE from the PANCREAS and supply it to the DUODENUM.
A malignant epithelial tumor with a glandular organization.
A nodular organ in the ABDOMEN that contains a mixture of ENDOCRINE GLANDS and EXOCRINE GLANDS. The small endocrine portion consists of the ISLETS OF LANGERHANS secreting a number of hormones into the blood stream. The large exocrine portion (EXOCRINE PANCREAS) is a compound acinar gland that secretes several digestive enzymes into the pancreatic ductal system that empties into the DUODENUM.
The evacuation of food from the stomach into the duodenum.
Veins which return blood from the intestines; the inferior mesenteric vein empties into the splenic vein, the superior mesenteric vein joins the splenic vein to form the portal vein.
Congenital structural abnormalities of the DIGESTIVE SYSTEM.
Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.
An area occupying the most posterior aspect of the ABDOMINAL CAVITY. It is bounded laterally by the borders of the quadratus lumborum muscles and extends from the DIAPHRAGM to the brim of the true PELVIS, where it continues as the pelvic extraperitoneal space.
The shortest and widest portion of the SMALL INTESTINE adjacent to the PYLORUS of the STOMACH. It is named for having the length equal to about the width of 12 fingers.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression.
Endoscopic examination, therapy or surgery of the luminal surface of the duodenum.
The arterial trunk that arises from the abdominal aorta and after a short course divides into the left gastric, common hepatic and splenic arteries.
INFLAMMATION of the PANCREAS that is characterized by recurring or persistent ABDOMINAL PAIN with or without STEATORRHEA or DIABETES MELLITUS. It is characterized by the irregular destruction of the pancreatic parenchyma which may be focal, segmental, or diffuse.
An abscess located in the abdominal cavity, i.e., the cavity between the diaphragm above and the pelvis below. (From Dorland, 27th ed)
Surgical formation of an opening into the DUODENUM.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)
Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)
The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum.
A Y-shaped surgical anastomosis of any part of the digestive system which includes the small intestine as the eventual drainage site.
A variety of surgical reconstructive procedures devised to restore gastrointestinal continuity, The two major classes of reconstruction are the Billroth I (gastroduodenostomy) and Billroth II (gastrojejunostomy) procedures.
The period of confinement of a patient to a hospital or other health facility.
Vein formed by the union (at the hilus of the spleen) of several small veins from the stomach, pancreas, spleen and mesentery.
Techniques, procedures, and therapies carried out on diseased organs in such a way to avoid complete removal of the organ and preserve the remaining organ function.
Any surgical procedure performed on the biliary tract.
Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES).
A branch of the celiac artery that distributes to the stomach, pancreas, duodenum, liver, gallbladder, and greater omentum.
An adenocarcinoma producing mucin in significant amounts. (From Dorland, 27th ed)
The insertion of a tube into the stomach, intestines, or other portion of the gastrointestinal tract to allow for the passage of food products, etc.
Not an aneurysm but a well-defined collection of blood and CONNECTIVE TISSUE outside the wall of a blood vessel or the heart. It is the containment of a ruptured blood vessel or heart, such as sealing a rupture of the left ventricle. False aneurysm is formed by organized THROMBUS and HEMATOMA in surrounding tissue.
Tumors or cancer of the DIGESTIVE SYSTEM.
Tomography using x-ray transmission and a computer algorithm to reconstruct the image.
A SOMATOSTATIN-secreting tumor derived from the pancreatic delta cells (SOMATOSTATIN-SECRETING CELLS). It is also found in the INTESTINE. Somatostatinomas are associated with DIABETES MELLITUS; CHOLELITHIASIS; STEATORRHEA; and HYPOCHLORHYDRIA. The majority of somatostatinomas have the potential for METASTASIS.
Tumors or cancer of the BILE DUCTS.
Pathological conditions in the DUODENUM region of the small intestine (INTESTINE, SMALL).
The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include FLUID THERAPY which normalizes body fluids to restore WATER-ELECTROLYTE BALANCE.
A benign tumor of the pancreatic ISLET CELLS. Usually it involves the INSULIN-producing PANCREATIC BETA CELLS, as in INSULINOMA, resulting in HYPERINSULINISM.
Abnormal passage in any organ of the biliary tract or between biliary organs and other organs.
The largest bile duct. It is formed by the junction of the CYSTIC DUCT and the COMMON HEPATIC DUCT.
The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.
A short thick vein formed by union of the superior mesenteric vein and the splenic vein.
A large vessel supplying the whole length of the small intestine except the superior part of the duodenum. It also supplies the cecum and the ascending part of the colon and about half the transverse part of the colon. It arises from the anterior surface of the aorta below the celiac artery at the level of the first lumbar vertebra.
Hemorrhage following any surgical procedure. It may be immediate or delayed and is not restricted to the surgical wound.
Elements of limited time intervals, contributing to particular results or situations.
INFLAMMATION of the PANCREAS. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of CHRONIC PANCREATITIS (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are ALCOHOLIC PANCREATITIS and gallstone pancreatitis.
Short thick veins which return blood from the kidneys to the vena cava.
The period during a surgical operation.
Ultrasonography of internal organs using an ultrasound transducer sometimes mounted on a fiberoptic endoscope. In endosonography the transducer converts electronic signals into acoustic pulses or continuous waves and acts also as a receiver to detect reflected pulses from within the organ. An audiovisual-electronic interface converts the detected or processed echo signals, which pass through the electronics of the instrument, into a form that the technologist can evaluate. The procedure should not be confused with ENDOSCOPY which employs a special instrument called an endoscope. The "endo-" of endosonography refers to the examination of tissue within hollow organs, with reference to the usual ultrasonography procedure which is performed externally or transcutaneously.
An adenocarcinoma containing finger-like processes of vascular connective tissue covered by neoplastic epithelium, projecting into cysts or the cavity of glands or follicles. It occurs most frequently in the ovary and thyroid gland. (Stedman, 25th ed)
Jaundice, the condition with yellowish staining of the skin and mucous membranes, that is due to impaired BILE flow in the BILIARY TRACT, such as INTRAHEPATIC CHOLESTASIS, or EXTRAHEPATIC CHOLESTASIS.
Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes.
Hospitals with a much lower than average utilization by physicians and smaller number of procedures.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
The channels that collect and transport the bile secretion from the BILE CANALICULI, the smallest branch of the BILIARY TRACT in the LIVER, through the bile ductules, the bile ducts out the liver, and to the GALLBLADDER for storage.
A potent, long-acting synthetic SOMATOSTATIN octapeptide analog that inhibits secretion of GROWTH HORMONE and is used to treat hormone-secreting tumors; DIABETES MELLITUS; HYPOTENSION, ORTHOSTATIC; HYPERINSULINISM; hypergastrinemia; and small bowel fistula.
Loss of blood during a surgical procedure.
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
Procedures used to reconstruct, restore, or improve defective, damaged, or missing structures.

Delayed gastric emptying after Billroth I pylorus-preserving pancreatoduodenectomy: effect of postoperative time and cisapride. (1/601)

OBJECTIVE: To study the recovery course of gastric emptying after Billroth I pylorus-preserving pancreatoduodenectomy (PPPD) and therapeutic effects of cisapride. METHODS: To examine gastric emptying, acetaminophen was given, admixed in a pasty liquid meal, to 16 patients undergoing PPPD before surgery and at 1, 3, 6, 9, and 12 months after surgery. Cisapride was given orally to 10 patients before they received the acetaminophen regimen. Electrogastrography was performed at 2 weeks to 1 month after surgery in eight patients and at 6 to 12 months after surgery in seven patients. RESULTS: Gastric emptying was delayed but returned to the preoperative level by 6 months after surgery. Pretreatment with cisapride accelerated gastric emptying during months 1 to 6 but not during months 6 to 12 after surgery. Electrogastrography frequently showed tachygastria 2 weeks to 1 month after surgery, but seldom 6 to 12 months after surgery. CONCLUSIONS: After Billroth I PPPD, gastric emptying is delayed but recovers by 6 months after surgery. Tachygastria may play a part in the pathogenesis of delayed gastric emptying, but it can be treated with cisapride.  (+info)

Reexploration for periampullary carcinoma: resectability, perioperative results, pathology, and long-term outcome. (2/601)

OBJECTIVE: This single-institution experience retrospectively reviews the outcomes of patients undergoing reexploration for periampullary carcinoma at a high-volume center. SUMMARY BACKGROUND DATA: Many patients are referred to tertiary centers with periampullary carcinoma after their tumors were deemed unresectable at previous laparotomy. In carefully selected patients, tumor resection is often possible; however, the perioperative results and long-term outcome have not been well defined. METHODS: From November 1991 through December 1997, 78 patients who underwent previous exploratory laparotomy and/or palliative surgery for suspected periampullary carcinoma underwent reexploration. The operative outcome, resectability rate, pathology, and long-term survival rate were compared with 690 concurrent patients who had not undergone previous exploratory surgery. RESULTS: Fifty-two of the 78 patients (67%) undergoing reexploration underwent successful resection by pancreaticoduodenectomy; the remaining 26 patients (34%) were deemed to have unresectable disease. Compared with the 690 patients who had not undergone recent related surgery, the patients in the reoperative group were similar with respect to gender, race, and resectability rate but were significantly younger. The distribution of periampullary cancers by site in the reoperative group undergoing pancreaticoduodenectomy (n = 52) was 60%, 19%, 15%, and 6% for pancreatic, ampullary, distal bile duct, and duodenal tumors, respectively. These figures were similar to the 65%, 14%, 16% and 5% for resectable periampullary cancers found in the primary surgery group (n = 460). Intraoperative blood loss and transfusion requirements did not differ between the two groups. However, the mean operative time was 7.4 hours in the reoperative group, significantly longer than in the control group. On pathologic examination, reoperative patients had smaller tumors, and the percentage of patients with positive lymph nodes in the resection specimen was significantly less. The incidence of positive margins was similar between the two groups. Postoperative lengths of stay, complication rates, and perioperative mortality rates were not higher in reoperative patients. The long-term survival rate was similar between the two resected groups, with a median survival of 24 months in the reoperative group and 20 months in those without previous exploration. CONCLUSIONS: These data demonstrate that patients undergoing reoperation for periampullary carcinoma have similar resectability, perioperative morbidity and mortality, and long-term survival rates as patients undergoing initial exploration. The results suggest that selected patients considered to have unresectable disease at previous surgery should undergo restaging and reexploration at specialized high-volume centers.  (+info)

Prognostic value of MIB-1 index and DNA ploidy in resectable ampulla of Vater carcinoma. (3/601)

OBJECTIVE: To evaluate the prognostic value of the proliferative factors, MIB-1 index, DNA ploidy, and S-phase fraction, and further to determine the independent prognostic factors in ampulla of Vater carcinoma after pancreaticoduodenectomy. SUMMARY BACKGROUND DATA: Cell kinetics are important indicators of the biologic behavior of various human tumors, but only a few authors have reported the application of cell proliferative factors in ampulla of Vater carcinoma. METHODS: Patients undergoing pancreaticoduodenectomy for ampulla of Vater carcinoma were included. Proliferative factors, MIB-1 index, and DNA contents, measured by flow cytometry, were evaluated and compared with the conventional clinicopathologic factors. RESULTS: Ninety resectable ampulla of Vater carcinomas were included. By univariate analysis, MIB-1 index, DNA ploidy, S-phase fraction, stage, and lymph node status were significant prognostic factors. The 5-year survival rate was 40.7% for tumors with MIB-1 index < or =15% and 0% for those with MIB-1 index >15%. Diploid tumors had a significantly better prognosis than aneuploid. Outcomes of stage I and II tumors were more favorable than those of stage III and IV. After multivariate analysis, MIB-1 index, DNA ploidy, and stage remained as the independent prognostic factors. Among the three independent prognostic factors, MIB-1 index was the most powerful. CONCLUSIONS: Both MIB-1 index and DNA ploidy provide important prognostic value and potentially complement the conventional prognostic factors in resectable ampulla of Vater carcinoma. MIB-1 index is the most powerful independent prognostic factor.  (+info)

Pancreaticoduodenectomy with or without extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma: comparison of morbidity and mortality and short-term outcome. (4/601)

OBJECTIVE: This prospective, randomized, single-institution trial was designed to evaluate the end points of mortality, morbidity, and survival in patients undergoing standard versus radical (extended) pancreaticoduodenectomy (including distal gastrectomy and retroperitoneal lymphadenectomy). SUMMARY BACKGROUND DATA: Numerous retrospective reports and one prospective randomized trial have suggested that the performance of an extended lymphadenectomy in association with a pancreaticoduodenal resection may improve long-term survival for some patients with pancreatic and other periampullary adenocarcinomas. Many of these previously published studies can be criticized for their retrospective and nonrandomized designs, for the inclusion of nonconcurrent control groups, and for their small numbers. METHODS: Between April 1996 and December 1997, 114 patients with periampullary adenocarcinoma were enrolled in an ongoing, prospective, randomized trial at The Johns Hopkins Hospital. After intraoperative verification of completely resected periampullary adenocarcinoma, the patients were randomized to receive either a standard pancreaticoduodenectomy (removing only the peripancreatic lymph nodes en bloc with the specimen) or a radical pancreaticoduodenectomy (standard resection plus distal gastrectomy and retroperitoneal lymphadenectomy). All pathology specimens were reviewed and categorized. The postoperative morbidity, mortality, and short-term outcomes were examined. RESULTS: Of the 114 patients randomized, 56 underwent a standard pancreaticoduodenectomy and 58 a radical pancreaticoduodenectomy. The two groups were statistically similar with regard to age and gender, but there was a higher percentage of white patients in the radical group. All the patients in the radical group underwent distal gastric resection, whereas 86% of the patients in the standard group underwent pylorus preservation. The mean operative time in the radical group was 6.8 hours, compared with 6.2 hours in the standard group. There were no significant differences between the two groups with respect to the intraoperative blood loss, transfusion requirements, location of primary tumor, mean tumor size, positive lymph node status, or positive margin status. There were three deaths in the standard group and two in the radical group. The complication rates were 34% for the standard group and 40% for the radical group. Patients undergoing radical resection had a higher incidence of early delayed gastric emptying but had similar rates of other complications, such as pancreatic fistula, wound infection, intraabdominal abscess, and need for reoperation. The mean total number of lymph nodes resected was higher in the radical group. Of the 58 patients in the radical group, only 10% had metastatic carcinoma in the resected retroperitoneal lymph nodes, and none of those patients had the retroperitoneal nodes as the only site of lymph node involvement. The 1-year actuarial survival rate for patients surviving the immediate postoperative periods was 77% for the standard resection group and 83% for the radical resection group. CONCLUSIONS: These data demonstrate that radical pancreaticoduodenectomy (with the addition of a distal gastrectomy and extended retroperitoneal lymphadenectomy to a standard pancreaticoduodenectomy) can be performed with similar morbidity and mortality to standard pancreaticoduodenectomy. However, the survival data are not sufficiently mature and the numbers of patients enrolled are not adequate to allow firm conclusions to be drawn regarding survival benefit.  (+info)

Association of preoperative biliary drainage with postoperative outcome following pancreaticoduodenectomy. (5/601)

OBJECTIVE: To determine whether preoperative biliary instrumentation and preoperative biliary drainage are associated with increased morbidity and mortality rates after pancreaticoduodenectomy. SUMMARY BACKGROUND DATA: Pancreaticoduodenectomy is accompanied by a considerable rate of postoperative complications and potential death. Controversy exists regarding the impact of preoperative biliary instrumentation and preoperative biliary drainage on morbidity and mortality rates after pancreaticoduodenectomy. METHODS: Two hundred forty consecutive cases of pancreaticoduodenectomy performed between January 1994 and January 1997 were analyzed. Multiple preoperative, intraoperative, and postoperative variables were examined. Pearson chi square analysis or Fisher's exact test, when appropriate, was used for univariate comparison of all variables. Logistic regression was used for multivariate analysis. RESULTS: One hundred seventy-five patients (73%) underwent preoperative biliary instrumentation (endoscopic, percutaneous, or surgical instrumentation). One hundred twenty-six patients (53%) underwent preoperative biliary drainage (endoscopic stents, percutaneous drains/stents, or surgical drainage). The overall postoperative morbidity rate after pancreaticoduodenectomy was 48% (114/240). Infectious complications occurred in 34% (81/240) of patients. Intraabdominal abscess occurred in 14% (33/240) of patients. The postoperative mortality rate was 5% (12/240). Preoperative biliary drainage was determined to be the only statistically significant variable associated with complications (p = 0.025), infectious complications (p = 0.014), intraabdominal abscess (p = 0.022), and postoperative death (p = 0.037). Preoperative biliary instrumentation alone was not associated with complications, infectious complications, intraabdominal abscess, or postoperative death. CONCLUSIONS: Preoperative biliary drainage, but not preoperative biliary instrumentation alone, is associated with increased morbidity and mortality rates in patients undergoing pancreaticoduodenectomy. This suggests that preoperative biliary drainage should be avoided whenever possible in patients with potentially resectable pancreatic and peripancreatic lesions. Such a change in current preoperative management may improve patient outcome after pancreaticoduodenectomy.  (+info)

A case of intraabdominal bleeding following pancreatoduodenectomy successfully treated by transcatheter arterial embolization. (6/601)

A 58-year-old male underwent pancreatoduodenectomy based on a diagnosis of middle bile duct cancer. Because abdominal drainage revealed bile leakage 5 days postoperatively, leakage at the site of cholangiojejunostomy was diagnosed, and continuous aspiration was performed. Seventeen days postoperatively, pus was discharged through the abdominal drain. Because bleeding was detected by abdominal drainage, and shock ensued 20 days postoperatively, emergency abdominal angiography was carried out to identify the bleeding site. A false aneurysm in the proper hepatic artery and extravasation from the gastroduodenal artery stump were recognized, and therefore, the proper hepatic artery and common hepatic artery were embolized at a site distal to the false aneurysm using microcoils. Celiac arteriography after transcatheter arterial embolization (TAE) did not show extravasation, and revealed blood flow from the right inferior phrenic artery to the liver. Liver function was normal after TAE, and the patient recovered and was discharged from the hospital 54 days postoperatively. This paper presents a patient in whom intraabdominal bleeding due to leakage at the site of cholangiojejunostomy complicated by infection was successfully treated by hemostasis with TAE.  (+info)

Preoperative chemoradiation for patients with pancreatic cancer: toxicity of endobiliary stents. (7/601)

PURPOSE: A recent multicenter study of preoperative chemoradiation and pancreaticoduodenectomy for localized pancreatic adenocarcinoma suggested that biliary stent-related complications are frequent and severe and may prevent the delivery of all components of multimodality therapy in many patients. The present study was designed to evaluate the rates of hepatic toxicity and biliary stent-related complications and to evaluate the impact of this morbidity on the delivery of preoperative chemoradiation for pancreatic cancer at a tertiary care cancer center. PATIENTS AND METHODS: Preoperative chemoradiation was used in 154 patients with resectable pancreatic adenocarcinoma (142 patients, 92%) or other periampullary tumors (12 patients, 8%). Patients were treated with preoperative fluorouracil (115 patients), paclitaxel (37 patients), or gemcitabine (two patients) plus concurrent rapid-fractionation (30 Gy; 123 patients) or standard-fractionation (50.4 Gy; 31 patients) radiation therapy. The incidences of hepatic toxicity and biliary stent-related complications were evaluated during chemoradiation and the immediate 3- to 4-week postchemoradiation preoperative period. RESULTS: Nonoperative biliary decompression was performed in 101 (66%) of 154 patients (endobiliary stent placement in 77 patients and percutaneous transhepatic catheter placement in 24 patients). Stent-related complications (occlusion or migration) occurred in 15 patients. Inpatient hospitalization for antibiotics and stent exchange was necessary in seven of 15 patients (median hospital stay, 3 days). No patient experienced uncontrolled biliary sepsis, hepatic abscess, or stent-related death. CONCLUSION: Preoperative chemoradiation for pancreatic cancer is associated with low rates of hepatic toxicity and biliary stent-related complications. The need for biliary decompression is not a clinically significant concern in the delivery of preoperative therapy to patients with localized pancreatic cancer.  (+info)

Treatment options for villous adenoma of the ampulla of Vater. (8/601)

INTRODUCTION: Duodenal villous adenoma arising from the ampulla of Vater has a high risk of malignant development. Excluding associated malignant disease prior to resection of an adenoma of the ampulla is not always possible. Therefore, the surgical procedure of choice to treat this rare tumour is still controversial. OBJECTIVE: To evaluate retrospectively results of treatment of villous adenoma arising from ampulla of Vater with dysplasia or associated carcinoma limited to the ampulla. PATIENTS AND METHODS: From 1985 to 1996, eight patients have been diagnosed with ampullary villous adenoma suitable for resection. We have reviewed treatment, morbidity, mortality, follow-up and final outcome. RESULTS: Pancreatoduodenectomy (PD) was performed in 4 patients. Transduodenal ampullectomy and endoscopic resection was performed in 2 patients each. There was no perioperative mortality. None of the patients had biliary, pancreatic or intestinal leakage but two patients who underwent PD had minor postoperative complications. The mean follow-up was 44 (range: 6-132) months. Villous adenoma was associated with adenocarcinoma in 50% of the cases (4/8 patients). During the follow-up both patients who underwent transduodenal ampullectomy developed recurrent disease. All patients initially treated by PD are alive without evidence of recurrent disease. CONCLUSIONS: Treatment of villous adenoma of the ampulla must be individualized within certain limits. In our series, PD achieve good results and it appears to be the procedure of choice in order to treat villous adenomas with proved presence of carcinoma, carcinoma in situ or severe dysplasia. Endoscopic or local resection may be appropriate for small benign tumours in high risk patients.  (+info)

Pancreaticoduodenectomy, also known as the Whipple procedure, is a complex surgical operation that involves the removal of the head of the pancreas, the duodenum (the first part of the small intestine), the gallbladder, and the distal common bile duct. In some cases, a portion of the stomach may also be removed. The remaining parts of the pancreas, bile duct, and intestines are then reconnected to allow for the digestion of food and drainage of bile.

This procedure is typically performed as a treatment for various conditions affecting the pancreas, such as tumors (including pancreatic cancer), chronic pancreatitis, or traumatic injuries. It is a major surgical operation that requires significant expertise and experience to perform safely and effectively.

A pancreatic fistula is an abnormal connection or passage between the pancreas and another organ, often the digestive system. It usually occurs as a complication following trauma, surgery, or inflammation of the pancreas (such as pancreatitis). The pancreas secretes digestive enzymes, and when these enzymes escape the pancreas through a damaged or disrupted duct, they can cause irritation and inflammation in nearby tissues, leading to the formation of a fistula.

Pancreatic fistulas are typically characterized by the drainage of pancreatic fluid, which contains high levels of digestive enzymes, into other parts of the body. This can lead to various symptoms, including abdominal pain, swelling, fever, and malnutrition. Treatment may involve surgical repair of the fistula, as well as supportive care such as antibiotics, nutritional support, and drainage of any fluid collections.

Pancreaticojejunostomy is a surgical procedure that involves connecting the pancreas to a portion of the small intestine called the jejunum. This connection is typically created after the head of the pancreas has been removed, as in the case of a pancreaticoduodenectomy (or "Whipple") procedure. The purpose of this anastomosis is to allow digestive enzymes from the pancreas to flow into the small intestine, where they can aid in the digestion of food.

The connection between the pancreas and jejunum can be created using several different techniques, including a hand-sewn anastomosis or a stapled anastomosis. The choice of technique may depend on various factors, such as the patient's individual anatomy, the surgeon's preference, and the reason for the surgery.

Pancreaticojejunostomy is a complex surgical procedure that requires significant skill and expertise to perform. It carries risks such as leakage of pancreatic enzymes into the abdominal cavity, which can lead to serious complications such as infection, bleeding, or even organ failure. As such, it is typically performed by experienced surgeons in specialized medical centers.

The ampulla of Vater, also known as hepatopancreatic ampulla, is a dilated portion of the common bile duct where it joins the main pancreatic duct and empties into the second part of the duodenum. It serves as a conduit for both bile from the liver and digestive enzymes from the pancreas to reach the small intestine, facilitating the digestion and absorption of nutrients. The ampulla of Vater is surrounded by a muscular sphincter, the sphincter of Oddi, which controls the flow of these secretions into the duodenum.

Common bile duct neoplasms refer to abnormal growths that can occur in the common bile duct, which is a tube that carries bile from the liver and gallbladder into the small intestine. These growths can be benign or malignant (cancerous).

Benign neoplasms of the common bile duct include papillomas, adenomas, and leiomyomas. Malignant neoplasms are typically adenocarcinomas, which arise from the glandular cells lining the duct. Other types of malignancies that can affect the common bile duct include cholangiocarcinoma, gallbladder carcinoma, and metastatic cancer from other sites.

Symptoms of common bile duct neoplasms may include jaundice (yellowing of the skin and eyes), abdominal pain, dark urine, and light-colored stools. Diagnosis may involve imaging tests such as CT scans or MRCP (magnetic resonance cholangiopancreatography) and biopsy to confirm the type of neoplasm. Treatment options depend on the type and stage of the neoplasm and may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.

Pancreatic neoplasms refer to abnormal growths in the pancreas that can be benign or malignant. The pancreas is a gland located behind the stomach that produces hormones and digestive enzymes. Pancreatic neoplasms can interfere with the normal functioning of the pancreas, leading to various health complications.

Benign pancreatic neoplasms are non-cancerous growths that do not spread to other parts of the body. They are usually removed through surgery to prevent any potential complications, such as blocking the bile duct or causing pain.

Malignant pancreatic neoplasms, also known as pancreatic cancer, are cancerous growths that can invade and destroy surrounding tissues and organs. They can also spread (metastasize) to other parts of the body, such as the liver, lungs, or bones. Pancreatic cancer is often aggressive and difficult to treat, with a poor prognosis.

There are several types of pancreatic neoplasms, including adenocarcinomas, neuroendocrine tumors, solid pseudopapillary neoplasms, and cystic neoplasms. The specific type of neoplasm is determined through various diagnostic tests, such as imaging studies, biopsies, and blood tests. Treatment options depend on the type, stage, and location of the neoplasm, as well as the patient's overall health and preferences.

Duodenal neoplasms refer to abnormal growths in the duodenum, which is the first part of the small intestine that receives digestive secretions from the pancreas and bile duct. These growths can be benign or malignant (cancerous).

Benign neoplasms include adenomas, leiomyomas, lipomas, and hamartomas. They are usually slow-growing and do not spread to other parts of the body. However, they may cause symptoms such as abdominal pain, bleeding, or obstruction of the intestine.

Malignant neoplasms include adenocarcinomas, neuroendocrine tumors (carcinoids), lymphomas, and sarcomas. They are more aggressive and can invade surrounding tissues and spread to other parts of the body. Symptoms may include abdominal pain, weight loss, jaundice, anemia, or bowel obstruction.

The diagnosis of duodenal neoplasms is usually made through imaging tests such as CT scans, MRI, or endoscopy with biopsy. Treatment depends on the type and stage of the tumor and may include surgery, chemotherapy, radiation therapy, or a combination of these modalities.

A pancreatectomy is a surgical procedure in which all or part of the pancreas is removed. There are several types of pancreatectomies, including:

* **Total pancreatectomy:** Removal of the entire pancreas, as well as the spleen and nearby lymph nodes. This type of pancreatectomy is usually done for patients with cancer that has spread throughout the pancreas or for those who have had multiple surgeries to remove pancreatic tumors.
* **Distal pancreatectomy:** Removal of the body and tail of the pancreas, as well as nearby lymph nodes. This type of pancreatectomy is often done for patients with tumors in the body or tail of the pancreas.
* **Partial (or segmental) pancreatectomy:** Removal of a portion of the head or body of the pancreas, as well as nearby lymph nodes. This type of pancreatectomy is often done for patients with tumors in the head or body of the pancreas that can be removed without removing the entire organ.
* **Pylorus-preserving pancreaticoduodenectomy (PPPD):** A type of surgery used to treat tumors in the head of the pancreas, as well as other conditions such as chronic pancreatitis. In this procedure, the head of the pancreas, duodenum, gallbladder, and bile duct are removed, but the stomach and lower portion of the esophagus (pylorus) are left in place.

After a pancreatectomy, patients may experience problems with digestion and blood sugar regulation, as the pancreas plays an important role in these functions. Patients may need to take enzyme supplements to help with digestion and may require insulin therapy to manage their blood sugar levels.

Pancreatic diseases refer to a group of medical conditions that affect the structure and function of the pancreas, a vital organ located in the abdomen. The pancreas has two main functions: an exocrine function, which involves the production of digestive enzymes that help break down food in the small intestine, and an endocrine function, which involves the production of hormones such as insulin and glucagon that regulate blood sugar levels.

Pancreatic diseases can be broadly classified into two categories: inflammatory and non-inflammatory. Inflammatory pancreatic diseases include conditions such as acute pancreatitis, which is characterized by sudden inflammation of the pancreas, and chronic pancreatitis, which is a long-term inflammation that can lead to scarring and loss of function.

Non-inflammatory pancreatic diseases include conditions such as pancreatic cancer, which is a malignant tumor that can arise from the cells of the pancreas, and benign tumors such as cysts or adenomas. Other non-inflammatory conditions include pancreatic insufficiency, which can occur when the pancreas does not produce enough digestive enzymes, and diabetes mellitus, which can result from impaired insulin production or action.

Overall, pancreatic diseases can have serious consequences on a person's health and quality of life, and early diagnosis and treatment are essential for optimal outcomes.

The pylorus is the lower, narrow part of the stomach that connects to the first part of the small intestine (duodenum). It consists of the pyloric canal, which is a short muscular tube, and the pyloric sphincter, a circular muscle that controls the passage of food from the stomach into the duodenum. The pylorus regulates the entry of chyme (partially digested food) into the small intestine by adjusting the size and frequency of the muscular contractions that push the chyme through the pyloric sphincter. This process helps in further digestion and absorption of nutrients in the small intestine.

Postoperative complications refer to any unfavorable condition or event that occurs during the recovery period after a surgical procedure. These complications can vary in severity and may include, but are not limited to:

1. Infection: This can occur at the site of the incision or inside the body, such as pneumonia or urinary tract infection.
2. Bleeding: Excessive bleeding (hemorrhage) can lead to a drop in blood pressure and may require further surgical intervention.
3. Blood clots: These can form in the deep veins of the legs (deep vein thrombosis) and can potentially travel to the lungs (pulmonary embolism).
4. Wound dehiscence: This is when the surgical wound opens up, which can lead to infection and further complications.
5. Pulmonary issues: These include atelectasis (collapsed lung), pneumonia, or respiratory failure.
6. Cardiovascular problems: These include abnormal heart rhythms (arrhythmias), heart attack, or stroke.
7. Renal failure: This can occur due to various reasons such as dehydration, blood loss, or the use of certain medications.
8. Pain management issues: Inadequate pain control can lead to increased stress, anxiety, and decreased mobility.
9. Nausea and vomiting: These can be caused by anesthesia, opioid pain medication, or other factors.
10. Delirium: This is a state of confusion and disorientation that can occur in the elderly or those with certain medical conditions.

Prompt identification and management of these complications are crucial to ensure the best possible outcome for the patient.

Pancreatic ductal carcinoma (PDC) is a specific type of cancer that forms in the ducts that carry digestive enzymes out of the pancreas. It's the most common form of exocrine pancreatic cancer, making up about 90% of all cases.

The symptoms of PDC are often vague and can include abdominal pain, jaundice (yellowing of the skin and eyes), unexplained weight loss, and changes in bowel movements. These symptoms can be similar to those caused by other less serious conditions, which can make diagnosis difficult.

Pancreatic ductal carcinoma is often aggressive and difficult to treat. The prognosis for PDC is generally poor, with a five-year survival rate of only about 9%. Treatment options may include surgery, chemotherapy, radiation therapy, or a combination of these approaches. However, because PDC is often not detected until it has advanced, treatment is frequently focused on palliative care to relieve symptoms and improve quality of life.

Gastroparesis is a gastrointestinal disorder that affects the stomach's normal motility, resulting in the delayed emptying of food from the stomach into the small intestine. The term "gastroparesis" literally means "stomach paralysis," although the stomach doesn't actually become paralyzed in this condition. Instead, the muscles of the stomach wall become weakened or damaged, leading to a decrease in their ability to contract and push food through the digestive tract effectively.

The causes of gastroparesis can vary, but some common reasons include diabetes (both type 1 and type 2), viral infections, surgery involving the vagus nerve (which controls stomach muscle contractions), certain medications (such as narcotics, antidepressants, and high blood pressure drugs), gastroesophageal reflux disease (GERD), scleroderma, Parkinson's disease, multiple sclerosis, and Amyloidosis.

Symptoms of gastroparesis may include nausea, vomiting, feeling full quickly after starting to eat, bloating, heartburn, abdominal pain, lack of appetite, and unintended weight loss. These symptoms can significantly impact a person's quality of life and make it difficult for them to maintain proper nutrition.

Diagnosis typically involves a thorough medical history, physical examination, and various tests such as upper endoscopy, gastric emptying studies (such as the scintigraphy scan), and manometry to assess stomach muscle function. Treatment options may include dietary modifications, medications to stimulate stomach contractions or reduce symptoms like nausea and vomiting, botulinum toxin injections, electrical stimulation of the stomach muscles, or, in severe cases, feeding tubes or surgery.

A jejunostomy is a surgical procedure where an opening (stoma) is created in the lower part of the small intestine, called the jejunum. This stoma allows for the passage of nutrients and digestive enzymes from the small intestine into a tube or external pouch, bypassing the mouth, esophagus, stomach, and upper small intestine (duodenum).

Jejunostomy is typically performed to provide enteral nutrition support in patients who are unable to consume food or liquids by mouth due to various medical conditions such as dysphagia, gastroparesis, bowel obstruction, or after certain surgical procedures. The jejunostomy tube can be used for short-term or long-term nutritional support, depending on the patient's needs and underlying medical condition.

The pancreatic ducts are a set of tubular structures within the pancreas that play a crucial role in the digestive system. The main pancreatic duct, also known as the duct of Wirsung, is responsible for transporting pancreatic enzymes and bicarbonate-rich fluid from the pancreas to the duodenum, which is the first part of the small intestine.

The exocrine portion of the pancreas contains numerous smaller ducts called interlobular ducts and intralobular ducts that merge and ultimately join the main pancreatic duct. This system ensures that the digestive enzymes and fluids produced by the pancreas are effectively delivered to the small intestine, where they aid in the breakdown and absorption of nutrients from food.

In addition to the main pancreatic duct, there is an accessory pancreatic duct, also known as Santorini's duct, which can sometimes join the common bile duct before emptying into the duodenum through a shared opening called the ampulla of Vater. However, in most individuals, the accessory pancreatic duct usually drains into the main pancreatic duct before entering the duodenum.

Adenocarcinoma is a type of cancer that arises from glandular epithelial cells. These cells line the inside of many internal organs, including the breasts, prostate, colon, and lungs. Adenocarcinomas can occur in any of these organs, as well as in other locations where glands are present.

The term "adenocarcinoma" is used to describe a cancer that has features of glandular tissue, such as mucus-secreting cells or cells that produce hormones. These cancers often form glandular structures within the tumor mass and may produce mucus or other substances.

Adenocarcinomas are typically slow-growing and tend to spread (metastasize) to other parts of the body through the lymphatic system or bloodstream. They can be treated with surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these treatments. The prognosis for adenocarcinoma depends on several factors, including the location and stage of the cancer, as well as the patient's overall health and age.

The pancreas is a glandular organ located in the abdomen, posterior to the stomach. It has both exocrine and endocrine functions. The exocrine portion of the pancreas consists of acinar cells that produce and secrete digestive enzymes into the duodenum via the pancreatic duct. These enzymes help in the breakdown of proteins, carbohydrates, and fats in food.

The endocrine portion of the pancreas consists of clusters of cells called islets of Langerhans, which include alpha, beta, delta, and F cells. These cells produce and secrete hormones directly into the bloodstream, including insulin, glucagon, somatostatin, and pancreatic polypeptide. Insulin and glucagon are critical regulators of blood sugar levels, with insulin promoting glucose uptake and storage in tissues and glucagon stimulating glycogenolysis and gluconeogenesis to raise blood glucose when it is low.

Gastric emptying is the process by which the stomach empties its contents into the small intestine. In medical terms, it refers to the rate and amount of food that leaves the stomach and enters the duodenum, which is the first part of the small intestine. This process is regulated by several factors, including the volume and composition of the meal, hormonal signals, and neural mechanisms. Abnormalities in gastric emptying can lead to various gastrointestinal symptoms and disorders, such as gastroparesis, where the stomach's ability to empty food is delayed.

The mesenteric veins are a set of blood vessels that are responsible for draining deoxygenated blood from the small and large intestines. There are two main mesenteric veins: the superior mesenteric vein and the inferior mesenteric vein. The superior mesenteric vein drains blood from the majority of the small intestine, as well as the ascending colon and proximal two-thirds of the transverse colon. The inferior mesenteric vein drains blood from the distal third of the transverse colon, descending colon, sigmoid colon, and rectum. These veins ultimately drain into the portal vein, which carries the blood to the liver for further processing.

The digestive system is a complex series of organs and glands that process food. Abnormalities in the digestive system can refer to a wide range of conditions that affect any part of the system, including the esophagus, stomach, small intestine, large intestine, liver, pancreas, and gallbladder. These abnormalities can be present at birth (congenital) or acquired later in life due to various factors such as infection, inflammation, injury, or disease.

Some examples of digestive system abnormalities include:

1. Gastroesophageal Reflux Disease (GERD): A condition where the stomach acid flows back into the esophagus, causing heartburn and damage to the esophageal lining.
2. Peptic Ulcers: Open sores that develop on the lining of the stomach or duodenum, often caused by bacterial infections or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
3. Inflammatory Bowel Disease (IBD): A group of chronic inflammatory conditions of the intestine, including Crohn's disease and ulcerative colitis.
4. Irritable Bowel Syndrome (IBS): A functional gastrointestinal disorder characterized by abdominal pain, bloating, and altered bowel habits.
5. Celiac Disease: An autoimmune disorder where the ingestion of gluten leads to damage in the small intestine.
6. Diverticulosis: The presence of small pouches or sacs that form on the lining of the intestine, which can become inflamed or infected (diverticulitis).
7. Hiatal Hernia: A condition where a portion of the stomach protrudes through the diaphragm into the chest cavity.
8. Hepatitis: Inflammation of the liver, often caused by viral infections or toxins.
9. Cirrhosis: A chronic liver disease characterized by scarring and loss of liver function, often due to long-term alcohol abuse or hepatitis.
10. Gallstones: Small, hard deposits that form in the gallbladder and can cause pain and inflammation.

These are just a few examples of gastrointestinal disorders, and there are many others. If you are experiencing symptoms such as abdominal pain, bloating, diarrhea, constipation, or difficulty swallowing, it is important to speak with your healthcare provider to determine the cause and develop an appropriate treatment plan.

Surgical anastomosis is a medical procedure that involves the connection of two tubular structures, such as blood vessels or intestines, to create a continuous passage. This technique is commonly used in various types of surgeries, including vascular, gastrointestinal, and orthopedic procedures.

During a surgical anastomosis, the ends of the two tubular structures are carefully prepared by removing any damaged or diseased tissue. The ends are then aligned and joined together using sutures, staples, or other devices. The connection must be secure and leak-free to ensure proper function and healing.

The success of a surgical anastomosis depends on several factors, including the patient's overall health, the location and condition of the structures being joined, and the skill and experience of the surgeon. Complications such as infection, bleeding, or leakage can occur, which may require additional medical intervention or surgery.

Proper postoperative care is also essential to ensure the success of a surgical anastomosis. This may include monitoring for signs of complications, administering medications to prevent infection and promote healing, and providing adequate nutrition and hydration.

The retroperitoneal space refers to the area within the abdominal cavity that is located behind (retro) the peritoneum, which is the smooth serous membrane that lines the inner wall of the abdomen and covers the abdominal organs. This space is divided into several compartments and contains vital structures such as the kidneys, adrenal glands, pancreas, duodenum, aorta, and vena cava.

The retroperitoneal space can be further categorized into two regions:

1. The posterior pararenal space, which is lateral to the psoas muscle and contains fat tissue.
2. The perirenal space, which surrounds the kidneys and adrenal glands and is filled with fatty connective tissue.

Disorders or conditions affecting the retroperitoneal space may include infections, tumors, hematomas, or inflammation, which can lead to various symptoms depending on the specific structures involved. Imaging techniques such as CT scans or MRI are commonly used to diagnose and assess retroperitoneal pathologies.

The duodenum is the first part of the small intestine, immediately following the stomach. It is a C-shaped structure that is about 10-12 inches long and is responsible for continuing the digestion process that begins in the stomach. The duodenum receives partially digested food from the stomach through the pyloric valve and mixes it with digestive enzymes and bile produced by the pancreas and liver, respectively. These enzymes help break down proteins, fats, and carbohydrates into smaller molecules, allowing for efficient absorption in the remaining sections of the small intestine.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

Drainage, in medical terms, refers to the removal of excess fluid or accumulated collections of fluids from various body parts or spaces. This is typically accomplished through the use of medical devices such as catheters, tubes, or drains. The purpose of drainage can be to prevent the buildup of fluids that may cause discomfort, infection, or other complications, or to treat existing collections of fluid such as abscesses, hematomas, or pleural effusions. Drainage may also be used as a diagnostic tool to analyze the type and composition of the fluid being removed.

Gastrostomy is a surgical procedure that creates an opening through the abdominal wall into the stomach. This opening, called a stoma or gastrostomy tract, allows for the passage of a tube (gastrostomy tube) that can be used to provide enteral nutrition and hydration directly into the stomach when a person is unable to consume food or fluids by mouth due to various medical conditions such as dysphagia, neurological disorders, or head and neck cancers.

Gastrostomy tubes come in different types and sizes, including percutaneous endoscopic gastrostomy (PEG) tubes, laparoscopic gastrostomy tubes, and open surgical gastrostomy tubes. The choice of the procedure depends on various factors such as the patient's medical condition, anatomy, and overall health status.

The primary purpose of a gastrostomy is to ensure adequate nutrition and hydration for individuals who have difficulty swallowing or are unable to consume enough food or fluids by mouth to meet their nutritional needs. It can also help prevent complications associated with prolonged fasting, such as malnutrition, dehydration, and weight loss.

Duodenoscopy is a medical procedure that involves the insertion of a duodenoscope, which is a flexible, lighted tube with a camera and tiny tools on the end, through the mouth and down the throat to examine the upper part of the small intestine (duodenum) and the opening of the bile and pancreatic ducts.

During the procedure, the doctor can take tissue samples for biopsy, remove polyps or other abnormal growths, or perform other interventions as needed. Duodenoscopy is commonly used to diagnose and treat conditions such as gastrointestinal bleeding, inflammation, infection, and cancer.

It's important to note that duodenoscopes have been associated with the spread of antibiotic-resistant bacteria in some cases, so healthcare providers must follow strict cleaning and disinfection protocols to minimize this risk.

The celiac artery, also known as the anterior abdominal aortic trunk, is a major artery that originates from the abdominal aorta and supplies oxygenated blood to the foregut, which includes the stomach, liver, spleen, pancreas, and upper part of the duodenum. It branches into three main branches: the left gastric artery, the splenic artery, and the common hepatic artery. The celiac artery plays a crucial role in providing blood to these vital organs, and any disruption or damage to it can lead to serious health consequences.

Chronic pancreatitis is a long-standing inflammation of the pancreas that leads to irreversible structural changes and impaired function of the pancreas. It is characterized by recurrent or persistent abdominal pain, often radiating to the back, and maldigestion with steatorrhea (fatty stools) due to exocrine insufficiency. The pancreatic damage results from repeated episodes of acute pancreatitis, alcohol abuse, genetic predisposition, or autoimmune processes. Over time, the pancreas may lose its ability to produce enough digestive enzymes and hormones like insulin, which can result in diabetes mellitus. Chronic pancreatitis also increases the risk of developing pancreatic cancer.

An abdominal abscess is a localized collection of pus in the abdominal cavity, caused by an infection. It can occur as a result of complications from surgery, trauma, or inflammatory conditions such as appendicitis or diverticulitis. Symptoms may include abdominal pain, fever, and tenderness at the site of the abscess. Abdominal abscesses can be serious and require medical treatment, which may include antibiotics, drainage of the abscess, or surgery.

Duodenostomy is a surgical procedure that creates an opening (stoma) into the duodenum, which is the first part of the small intestine. This procedure is typically performed to divert the flow of digestive secretions and contents away from a diseased or obstructed area of the gastrointestinal tract.

A duodenostomy may be created as a temporary measure to allow a portion of the intestine to heal or as a permanent solution for conditions such as chronic inflammatory bowel disease, cancer, or congenital abnormalities. The stoma can be located on the abdominal wall, allowing for the external drainage of digestive secretions and contents into a collection bag.

It is important to note that the specific medical definition and indications for duodenostomy may vary based on individual clinical context and patient needs. Therefore, it is always best to consult with a healthcare professional or medical expert for accurate information.

Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.

Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.

Postoperative care refers to the comprehensive medical treatment and nursing attention provided to a patient following a surgical procedure. The goal of postoperative care is to facilitate the patient's recovery, prevent complications, manage pain, ensure proper healing of the incision site, and maintain overall health and well-being until the patient can resume their normal activities.

This type of care includes monitoring vital signs, managing pain through medication or other techniques, ensuring adequate hydration and nutrition, helping the patient with breathing exercises to prevent lung complications, encouraging mobility to prevent blood clots, monitoring for signs of infection or other complications, administering prescribed medications, providing wound care, and educating the patient about postoperative care instructions.

The duration of postoperative care can vary depending on the type and complexity of the surgical procedure, as well as the individual patient's needs and overall health status. It may be provided in a hospital setting, an outpatient surgery center, or in the patient's home, depending on the level of care required.

Preoperative care refers to the series of procedures, interventions, and preparations that are conducted before a surgical operation. The primary goal of preoperative care is to ensure the patient's well-being, optimize their physical condition, reduce potential risks, and prepare them mentally and emotionally for the upcoming surgery.

Preoperative care typically includes:

1. Preoperative assessment: A thorough evaluation of the patient's overall health status, including medical history, physical examination, laboratory tests, and diagnostic imaging, to identify any potential risk factors or comorbidities that may impact the surgical procedure and postoperative recovery.
2. Informed consent: The process of ensuring the patient understands the nature of the surgery, its purpose, associated risks, benefits, and alternative treatment options. The patient signs a consent form indicating they have been informed and voluntarily agree to undergo the surgery.
3. Preoperative instructions: Guidelines provided to the patient regarding their diet, medication use, and other activities in the days leading up to the surgery. These instructions may include fasting guidelines, discontinuing certain medications, or arranging for transportation after the procedure.
4. Anesthesia consultation: A meeting with the anesthesiologist to discuss the type of anesthesia that will be used during the surgery and address any concerns related to anesthesia risks, side effects, or postoperative pain management.
5. Preparation of the surgical site: Cleaning and shaving the area where the incision will be made, as well as administering appropriate antimicrobial agents to minimize the risk of infection.
6. Medical optimization: Addressing any underlying medical conditions or correcting abnormalities that may negatively impact the surgical outcome. This may involve adjusting medications, treating infections, or managing chronic diseases such as diabetes.
7. Emotional and psychological support: Providing counseling, reassurance, and education to help alleviate anxiety, fear, or emotional distress related to the surgery.
8. Preoperative holding area: The patient is transferred to a designated area near the operating room where they are prepared for surgery by changing into a gown, having intravenous (IV) lines inserted, and receiving monitoring equipment.

By following these preoperative care guidelines, healthcare professionals aim to ensure that patients undergo safe and successful surgical procedures with optimal outcomes.

Pancreatic juice is an alkaline fluid secreted by the exocrine component of the pancreas, primarily containing digestive enzymes such as amylase, lipase, and trypsin. These enzymes aid in the breakdown of carbohydrates, fats, and proteins, respectively, in the small intestine during the digestion process. The bicarbonate ions present in pancreatic juice help neutralize the acidic chyme that enters the duodenum from the stomach, creating an optimal environment for enzymatic activity.

Roux-en-Y anastomosis is a type of surgical connection between two parts of the gastrointestinal tract, typically performed during gastric bypass surgery for weight loss. In this procedure, a small pouch is created from the upper stomach, and the remaining portion of the stomach is bypassed. The Roux limb, a segment of the small intestine, is then connected to both the pouch and the bypassed stomach, creating two separate channels for food and digestive juices to mix. This surgical technique helps to reduce the amount of food that can be consumed and absorbed, leading to weight loss.

Gastroenterostomy is a surgical procedure that creates an anastomosis (a connection or junction) between the stomach and the small intestine, usually between the stomach's lesser curvature and the jejunum (the second part of the small intestine). This procedure is often performed to bypass a diseased or obstructed portion of the gastrointestinal tract, such as in the case of gastric ulcers, tumors, or other conditions that prevent normal digestion and absorption.

There are different types of gastroenterostomy procedures, including:
1. Billroth I (or "gastroduodenostomy"): The stomach is connected directly to the duodenum (the first part of the small intestine).
2. Billroth II (or "gastrojejunostomy"): The stomach is connected to the jejunum, bypassing the duodenum.
3. Roux-en-Y gastrojejunostomy: A more complex procedure in which a portion of the jejunum is separated and reconnected further down the small intestine, creating a Y-shaped configuration. This type of gastroenterostomy is often used in bariatric surgery for weight loss.

The choice of gastroenterostomy technique depends on the specific medical condition being treated and the patient's overall health status.

"Length of Stay" (LOS) is a term commonly used in healthcare to refer to the amount of time a patient spends receiving care in a hospital, clinic, or other healthcare facility. It is typically measured in hours, days, or weeks and can be used as a metric for various purposes such as resource planning, quality assessment, and reimbursement. The length of stay can vary depending on the type of illness or injury, the severity of the condition, the patient's response to treatment, and other factors. It is an important consideration in healthcare management and can have significant implications for both patients and providers.

The splenic vein is a large, thin-walled vein that carries oxygenated blood from the spleen and pancreas to the liver. It is formed by the union of several smaller veins that drain the upper part of the stomach, the pancreas, and the left side of the colon (splenic flexure). The splenic vein runs along the top border of the pancreas and merges with the superior mesenteric vein to form the portal vein. This venous system allows for the filtration and detoxification of blood by the liver before it is distributed to the rest of the body.

Organ sparing treatments refer to medical interventions that are designed to preserve the structure and function of an organ, while still effectively treating the underlying disease or condition. These treatments can include surgical techniques, radiation therapy, or medications that aim to target specific cells or processes involved in the disease, while minimizing damage to healthy tissues.

Organ sparing treatments may be used in a variety of medical contexts, such as cancer treatment, where the goal is to eliminate malignant cells while preserving as much normal tissue as possible. For example, radiation therapy may be delivered with precise techniques that limit exposure to surrounding organs, or medications may be used to target specific receptors on cancer cells, reducing the need for more extensive surgical interventions.

Similarly, in the context of kidney disease, organ sparing treatments may include medications that help control blood pressure and reduce proteinuria (protein in the urine), which can help slow the progression of kidney damage and potentially delay or prevent the need for dialysis or transplantation.

Overall, organ sparing treatments represent an important area of medical research and practice, as they offer the potential to improve patient outcomes, reduce treatment-related morbidity, and maintain quality of life.

Biliary tract surgical procedures refer to a range of operations that involve the biliary system, which includes the liver, gallbladder, and bile ducts. These procedures can be performed for various reasons, including the treatment of gallstones, bile duct injuries, tumors, or other conditions affecting the biliary tract. Here are some examples of biliary tract surgical procedures:

1. Cholecystectomy: This is the surgical removal of the gallbladder, which is often performed to treat symptomatic gallstones or chronic cholecystitis (inflammation of the gallbladder). It can be done as an open procedure or laparoscopically.
2. Bile duct exploration: This procedure involves opening the common bile duct to remove stones, strictures, or tumors. It is often performed during a cholecystectomy if there is suspicion of common bile duct involvement.
3. Hepaticojejunostomy: This operation connects the liver's bile ducts directly to a portion of the small intestine called the jejunum, bypassing a damaged or obstructed segment of the biliary tract. It is often performed for benign or malignant conditions affecting the bile ducts.
4. Roux-en-Y hepaticojejunostomy: This procedure involves creating a Y-shaped limb of jejunum and connecting it to the liver's bile ducts, bypassing the common bile duct and duodenum. It is often performed for complex biliary tract injuries or malignancies.
5. Whipple procedure (pancreaticoduodenectomy): This extensive operation involves removing the head of the pancreas, the duodenum, a portion of the jejunum, the gallbladder, and the common bile duct. It is performed for malignancies involving the pancreas, bile duct, or duodenum.
6. Liver resection: This procedure involves removing a portion of the liver to treat primary liver tumors (hepatocellular carcinoma or cholangiocarcinoma) or metastatic cancer from other organs.
7. Biliary stenting or bypass: These minimally invasive procedures involve placing a stent or creating a bypass to relieve bile duct obstructions caused by tumors, strictures, or stones. They can be performed endoscopically (ERCP) or percutaneously (PTC).
8. Cholecystectomy: This procedure involves removing the gallbladder, often for symptomatic cholelithiasis (gallstones) or cholecystitis (inflammation of the gallbladder). It can be performed laparoscopically or open.
9. Biliary drainage: This procedure involves placing a catheter to drain bile from the liver or bile ducts, often for acute or chronic obstructions caused by tumors, strictures, or stones. It can be performed endoscopically (ERCP) or percutaneously (PTC).
10. Bilioenteric anastomosis: This procedure involves connecting the biliary tract to a portion of the small intestine, often for benign or malignant conditions affecting the bile ducts or pancreas. It can be performed open or laparoscopically.

Suture techniques refer to the various methods used by surgeons to sew or stitch together tissues in the body after an injury, trauma, or surgical incision. The main goal of suturing is to approximate and hold the edges of the wound together, allowing for proper healing and minimizing scar formation.

There are several types of suture techniques, including:

1. Simple Interrupted Suture: This is one of the most basic suture techniques where the needle is passed through the tissue at a right angle, creating a loop that is then tightened to approximate the wound edges. Multiple stitches are placed along the length of the incision or wound.
2. Continuous Locking Suture: In this technique, the needle is passed continuously through the tissue in a zigzag pattern, with each stitch locking into the previous one. This creates a continuous line of sutures that provides strong tension and support to the wound edges.
3. Running Suture: Similar to the continuous locking suture, this technique involves passing the needle continuously through the tissue in a straight line. However, instead of locking each stitch, the needle is simply passed through the previous loop before being tightened. This creates a smooth and uninterrupted line of sutures that can be easily removed after healing.
4. Horizontal Mattress Suture: In this technique, two parallel stitches are placed horizontally across the wound edges, creating a "mattress" effect that provides additional support and tension to the wound. This is particularly useful in deep or irregularly shaped wounds.
5. Vertical Mattress Suture: Similar to the horizontal mattress suture, this technique involves placing two parallel stitches vertically across the wound edges. This creates a more pronounced "mattress" effect that can help reduce tension and minimize scarring.
6. Subcuticular Suture: In this technique, the needle is passed just below the surface of the skin, creating a smooth and barely visible line of sutures. This is particularly useful in cosmetic surgery or areas where minimizing scarring is important.

The choice of suture technique depends on various factors such as the location and size of the wound, the type of tissue involved, and the patient's individual needs and preferences. Proper suture placement and tension are crucial for optimal healing and aesthetic outcomes.

The hepatic artery is a branch of the celiac trunk or abdominal aorta that supplies oxygenated blood to the liver. It typically divides into two main branches, the right and left hepatic arteries, which further divide into smaller vessels to supply different regions of the liver. The hepatic artery also gives off branches to supply other organs such as the gallbladder, pancreas, and duodenum.

It's worth noting that there is significant variability in the anatomy of the hepatic artery, with some individuals having additional branches or variations in the origin of the vessel. This variability can have implications for surgical procedures involving the liver and surrounding organs.

Adenocarcinoma, mucinous is a type of cancer that begins in the glandular cells that line certain organs and produce mucin, a substance that lubricates and protects tissues. This type of cancer is characterized by the presence of abundant pools of mucin within the tumor. It typically develops in organs such as the colon, rectum, lungs, pancreas, and ovaries.

Mucinous adenocarcinomas tend to have a distinct appearance under the microscope, with large pools of mucin pushing aside the cancer cells. They may also have a different clinical behavior compared to other types of adenocarcinomas, such as being more aggressive or having a worse prognosis in some cases.

It is important to note that while a diagnosis of adenocarcinoma, mucinous can be serious, the prognosis and treatment options may vary depending on several factors, including the location of the cancer, the stage at which it was diagnosed, and the individual's overall health.

I believe there might be a slight confusion in your question as intubation is a procedure typically related to the respiratory system rather than the gastrointestinal system.

Intubation generally refers to the process of inserting a tube into a specific part of the body. In the context of medical terminology, intubation usually means the placement of a flexible plastic tube through the mouth or nose and into the trachea (windpipe). This is done to secure and maintain an open airway during surgery or in emergency situations when a person cannot breathe on their own.

However, if you're referring to a procedure that involves the gastrointestinal tract, it might be "gastric lavage" or "nasogastric intubation."

Gastric lavage is a medical procedure where a tube is inserted through the mouth or nose, down the esophagus, and into the stomach to wash out its contents. This can help remove harmful substances from the stomach in case of poisoning.

Nasogastric intubation refers to the insertion of a thin, flexible tube through the nostril, down the back of the throat, and into the stomach. The tube can be used for various purposes, such as draining the stomach of fluids and air or administering nutrients and medications directly into the stomach.

I hope this clarifies any confusion. If you have further questions, please let me know!

A false aneurysm, also known as a pseudoaneurysm, is a type of aneurysm that occurs when there is a leakage or rupture of blood from a blood vessel into the surrounding tissues, creating a pulsating hematoma or collection of blood. Unlike true aneurysms, which involve a localized dilation or bulging of the blood vessel wall, false aneurysms do not have a complete covering of all three layers of the arterial wall (intima, media, and adventitia). Instead, they are typically covered by only one or two layers, such as the intima and adventitia, or by surrounding tissues like connective tissue or fascia.

False aneurysms can result from various factors, including trauma, infection, iatrogenic causes (such as medical procedures), or degenerative changes in the blood vessel wall. They are more common in arteries than veins and can occur in any part of the body. If left untreated, false aneurysms can lead to serious complications such as rupture, thrombosis, distal embolization, or infection. Treatment options for false aneurysms include surgical repair, endovascular procedures, or observation with regular follow-up imaging.

'Digestive System Neoplasms' refer to new and abnormal growths of tissue in the digestive system that can be benign or malignant. These growths are also known as tumors, and they can occur in any part of the digestive system, including the esophagus, stomach, small intestine, large intestine (colon and rectum), liver, bile ducts, pancreas, and gallbladder. Neoplasms in the digestive system can interfere with normal digestion and absorption of nutrients, cause bleeding, obstruct the digestive tract, and spread to other parts of the body (metastasis) if they are malignant.

Benign neoplasms are not cancerous and do not usually spread to other parts of the body. They can often be removed surgically and may not require further treatment. Malignant neoplasms, on the other hand, are cancerous and can invade nearby tissues and organs and spread to other parts of the body. Treatment for malignant neoplasms in the digestive system typically involves a combination of surgery, radiation therapy, and chemotherapy.

The causes of digestive system neoplasms are varied and include genetic factors, environmental exposures, lifestyle factors (such as diet and smoking), and infectious agents. Prevention strategies may include maintaining a healthy diet, avoiding tobacco and excessive alcohol consumption, practicing safe sex, getting vaccinated against certain viral infections, and undergoing regular screenings for certain types of neoplasms (such as colonoscopies for colorectal cancer).

X-ray computed tomography (CT or CAT scan) is a medical imaging method that uses computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional (tomographic) images (virtual "slices") of the body. These cross-sectional images can then be used to display detailed internal views of organs, bones, and soft tissues in the body.

The term "computed tomography" is used instead of "CT scan" or "CAT scan" because the machines take a series of X-ray measurements from different angles around the body and then use a computer to process these data to create detailed images of internal structures within the body.

CT scanning is a noninvasive, painless medical test that helps physicians diagnose and treat medical conditions. CT imaging provides detailed information about many types of tissue including lung, bone, soft tissue and blood vessels. CT examinations can be performed on every part of the body for a variety of reasons including diagnosis, surgical planning, and monitoring of therapeutic responses.

In computed tomography (CT), an X-ray source and detector rotate around the patient, measuring the X-ray attenuation at many different angles. A computer uses this data to construct a cross-sectional image by the process of reconstruction. This technique is called "tomography". The term "computed" refers to the use of a computer to reconstruct the images.

CT has become an important tool in medical imaging and diagnosis, allowing radiologists and other physicians to view detailed internal images of the body. It can help identify many different medical conditions including cancer, heart disease, lung nodules, liver tumors, and internal injuries from trauma. CT is also commonly used for guiding biopsies and other minimally invasive procedures.

In summary, X-ray computed tomography (CT or CAT scan) is a medical imaging technique that uses computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional images of the body. It provides detailed internal views of organs, bones, and soft tissues in the body, allowing physicians to diagnose and treat medical conditions.

Somatostatinoma is a rare type of neuroendocrine tumor that originates from the delta cells (D cells) of the diffuse endocrine system, which are responsible for producing and secreting somatostatin, a hormone that inhibits the release of several other hormones. These tumors can occur in various organs, but they most commonly arise in the pancreas and the small intestine (duodenum).

Somatostatinomas are typically slow-growing and can be functional or nonfunctional. Functional somatostatinomas actively produce and secrete excessive amounts of somatostatin, which can lead to a variety of clinical symptoms due to the inhibition of other hormones' functions. Nonfunctional somatostatinomas do not secrete significant amounts of somatostatin and are often discovered incidentally during imaging studies or when they cause local mass effects.

Common symptoms associated with functional somatostatinomas include diarrhea, abdominal pain, weight loss, fat malabsorption, and steatorrhea (fatty stools). They can also lead to diabetes mellitus due to the inhibition of insulin secretion. Additionally, these tumors may cause symptoms related to hormone deficiencies or the compression of nearby structures, depending on their location.

Diagnosis typically involves imaging studies such as CT scans, MRI, and PET scans, along with biochemical tests to measure somatostatin levels in the blood. A definitive diagnosis usually requires a tissue biopsy or surgical removal of the tumor for histopathological examination. Treatment options include surgery, chemotherapy, radiation therapy, and targeted therapies, depending on the stage and location of the tumor.

Bile duct neoplasms, also known as cholangiocarcinomas, refer to a group of malignancies that arise from the bile ducts. These are the tubes that carry bile from the liver to the gallbladder and small intestine. Bile duct neoplasms can be further classified based on their location as intrahepatic (within the liver), perihilar (at the junction of the left and right hepatic ducts), or distal (in the common bile duct).

These tumors are relatively rare, but their incidence has been increasing in recent years. They can cause a variety of symptoms, including jaundice, abdominal pain, weight loss, and fever. The diagnosis of bile duct neoplasms typically involves imaging studies such as CT or MRI scans, as well as blood tests to assess liver function. In some cases, a biopsy may be necessary to confirm the diagnosis.

Treatment options for bile duct neoplasms depend on several factors, including the location and stage of the tumor, as well as the patient's overall health. Surgical resection is the preferred treatment for early-stage tumors, while chemotherapy and radiation therapy may be used in more advanced cases. For patients who are not candidates for surgery, palliative treatments such as stenting or bypass procedures may be recommended to relieve symptoms and improve quality of life.

Duodenal diseases refer to a range of medical conditions that affect the duodenum, which is the first part of the small intestine. Here are some examples of duodenal diseases:

1. Duodenitis: This is inflammation of the duodenum, which can cause symptoms such as abdominal pain, nausea, vomiting, and bloating. Duodenitis can be caused by bacterial or viral infections, excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs), or chronic inflammation due to conditions like Crohn's disease.
2. Peptic ulcers: These are sores that develop in the lining of the duodenum, usually as a result of infection with Helicobacter pylori bacteria or long-term use of NSAIDs. Symptoms can include abdominal pain, bloating, and heartburn.
3. Duodenal cancer: This is a rare type of cancer that affects the duodenum. Symptoms can include abdominal pain, weight loss, and blood in the stool.
4. Celiac disease: This is an autoimmune disorder that causes the immune system to attack the lining of the small intestine in response to gluten, a protein found in wheat, barley, and rye. This can lead to inflammation and damage to the duodenum.
5. Duodenal diverticulosis: This is a condition in which small pouches form in the lining of the duodenum. While many people with duodenal diverticulosis do not experience symptoms, some may develop complications such as inflammation or infection.
6. Duodenal atresia: This is a congenital condition in which the duodenum does not form properly, leading to blockage of the intestine. This can cause symptoms such as vomiting and difficulty feeding in newborns.

Nutritional support is medical care that focuses on providing nutrition to individuals who are unable to consume or absorb adequate nutrients through their regular diet. This may include patients with chronic illnesses, eating disorders, swallowing difficulties, or those recovering from surgery or injury. Nutritional support can take many forms, including oral supplements, enteral feeding (tube feeding), and parenteral nutrition (intravenous feeding). The goal of nutritional support is to maintain or improve the patient's nutritional status, promote healing and recovery, enhance quality of life, and reduce complications associated with malnutrition.

An islet cell adenoma is a rare, typically benign tumor that develops in the islets of Langerhans, which are clusters of hormone-producing cells in the pancreas. The islets of Langerhans contain several types of cells, including beta cells that produce insulin, alpha cells that produce glucagon, and delta cells that produce somatostatin.

Islet cell adenomas can cause various endocrine disorders depending on the type of hormone-producing cells involved. For example, if the tumor consists mainly of beta cells, it may secrete excessive amounts of insulin, leading to hypoglycemia (low blood sugar). Conversely, if the tumor is composed primarily of alpha cells, it may produce too much glucagon, resulting in hyperglycemia (high blood sugar) and a condition known as glucagonoma.

Islet cell adenomas are usually slow-growing and small but can become quite large in some cases. They are typically diagnosed through imaging tests such as CT scans or MRI, and hormone levels may be measured to determine the type of cells involved. Treatment options include surgical removal of the tumor, medication to manage hormonal imbalances, and, in rare cases, radiofrequency ablation or embolization.

A biliary fistula is an abnormal connection or passage between the biliary system (which includes the gallbladder, bile ducts, and liver) and another organ or structure, usually in the abdominal cavity. This connection allows bile, which is a digestive fluid produced by the liver, to leak out of its normal pathway and into other areas of the body.

Biliary fistulas can occur as a result of trauma, surgery, infection, or inflammation in the biliary system. Symptoms may include abdominal pain, fever, jaundice (yellowing of the skin and eyes), nausea, vomiting, and clay-colored stools. Treatment typically involves addressing the underlying cause of the fistula, such as draining an infection or repairing damaged tissue, and diverting bile flow away from the site of the leak. In some cases, surgery may be necessary to repair the fistula.

The common bile duct is a duct that results from the union of the cystic duct (which drains bile from the gallbladder) and the common hepatic duct (which drains bile from the liver). The common bile duct transports bile, a digestive enzyme, from the liver and gallbladder to the duodenum, which is the first part of the small intestine.

The common bile duct runs through the head of the pancreas before emptying into the second part of the duodenum, either alone or in conjunction with the pancreatic duct, via a small opening called the ampulla of Vater. The common bile duct plays a crucial role in the digestion of fats by helping to break them down into smaller molecules that can be absorbed by the body.

Medical survival rate is a statistical measure used to determine the percentage of patients who are still alive for a specific period of time after their diagnosis or treatment for a certain condition or disease. It is often expressed as a five-year survival rate, which refers to the proportion of people who are alive five years after their diagnosis. Survival rates can be affected by many factors, including the stage of the disease at diagnosis, the patient's age and overall health, the effectiveness of treatment, and other health conditions that the patient may have. It is important to note that survival rates are statistical estimates and do not necessarily predict an individual patient's prognosis.

The portal vein is the large venous trunk that carries blood from the gastrointestinal tract, spleen, pancreas, and gallbladder to the liver. It is formed by the union of the superior mesenteric vein (draining the small intestine and a portion of the large intestine) and the splenic vein (draining the spleen and pancreas). The portal vein then divides into right and left branches within the liver, where the blood flows through the sinusoids and gets enriched with oxygen and nutrients before being drained by the hepatic veins into the inferior vena cava. This unique arrangement allows the liver to process and detoxify the absorbed nutrients, remove waste products, and regulate metabolic homeostasis.

The superior mesenteric artery (SMA) is a major artery that supplies oxygenated blood to the intestines, specifically the lower part of the duodenum, jejunum, ileum, cecum, ascending colon, and the first and second parts of the transverse colon. It originates from the abdominal aorta, located just inferior to the pancreas, and passes behind the neck of the pancreas before dividing into several branches to supply the intestines. The SMA is an essential vessel in the digestive system, providing blood flow for nutrient absorption and overall gut function.

Postoperative hemorrhage is a medical term that refers to bleeding that occurs after a surgical procedure. This condition can range from minor oozing to severe, life-threatening bleeding. Postoperative hemorrhage can occur soon after surgery or even several days later, as the surgical site begins to heal.

The causes of postoperative hemorrhage can vary, but some common factors include:

1. Inadequate hemostasis during surgery: This means that all bleeding was not properly controlled during the procedure, leading to bleeding after surgery.
2. Blood vessel injury: During surgery, blood vessels may be accidentally cut or damaged, causing bleeding after the procedure.
3. Coagulopathy: This is a condition in which the body has difficulty forming blood clots, increasing the risk of postoperative hemorrhage.
4. Use of anticoagulant medications: Medications that prevent blood clots can increase the risk of bleeding after surgery.
5. Infection: An infection at the surgical site can cause inflammation and bleeding.

Symptoms of postoperative hemorrhage may include swelling, pain, warmth, or discoloration around the surgical site, as well as signs of shock such as rapid heartbeat, low blood pressure, and confusion. Treatment for postoperative hemorrhage depends on the severity of the bleeding and may include medications to control bleeding, transfusions of blood products, or additional surgery to stop the bleeding.

In the field of medicine, "time factors" refer to the duration of symptoms or time elapsed since the onset of a medical condition, which can have significant implications for diagnosis and treatment. Understanding time factors is crucial in determining the progression of a disease, evaluating the effectiveness of treatments, and making critical decisions regarding patient care.

For example, in stroke management, "time is brain," meaning that rapid intervention within a specific time frame (usually within 4.5 hours) is essential to administering tissue plasminogen activator (tPA), a clot-busting drug that can minimize brain damage and improve patient outcomes. Similarly, in trauma care, the "golden hour" concept emphasizes the importance of providing definitive care within the first 60 minutes after injury to increase survival rates and reduce morbidity.

Time factors also play a role in monitoring the progression of chronic conditions like diabetes or heart disease, where regular follow-ups and assessments help determine appropriate treatment adjustments and prevent complications. In infectious diseases, time factors are crucial for initiating antibiotic therapy and identifying potential outbreaks to control their spread.

Overall, "time factors" encompass the significance of recognizing and acting promptly in various medical scenarios to optimize patient outcomes and provide effective care.

Pancreatitis is a medical condition characterized by inflammation of the pancreas, a gland located in the abdomen that plays a crucial role in digestion and regulating blood sugar levels. The inflammation can be acute (sudden and severe) or chronic (persistent and recurring), and it can lead to various complications if left untreated.

Acute pancreatitis often results from gallstones or excessive alcohol consumption, while chronic pancreatitis may be caused by long-term alcohol abuse, genetic factors, autoimmune conditions, or metabolic disorders like high triglyceride levels. Symptoms of acute pancreatitis include severe abdominal pain, nausea, vomiting, fever, and increased heart rate, while chronic pancreatitis may present with ongoing abdominal pain, weight loss, diarrhea, and malabsorption issues due to impaired digestive enzyme production. Treatment typically involves supportive care, such as intravenous fluids, pain management, and addressing the underlying cause. In severe cases, hospitalization and surgery may be necessary.

The renal veins are a pair of large veins that carry oxygen-depleted blood and waste products from the kidneys to the inferior vena cava, which is the largest vein in the body that returns blood to the heart. The renal veins are formed by the union of several smaller veins that drain blood from different parts of the kidney.

In humans, the right renal vein is shorter and passes directly into the inferior vena cava, while the left renal vein is longer and passes in front of the aorta before entering the inferior vena cava. The left renal vein also receives blood from the gonadal (testicular or ovarian) veins, suprarenal (adrenal) veins, and the lumbar veins.

It is important to note that the renal veins are vulnerable to compression by surrounding structures, such as the overlying artery or a tumor, which can lead to renal vein thrombosis, a serious condition that requires prompt medical attention.

The intraoperative period is the phase of surgical treatment that refers to the time during which the surgery is being performed. It begins when the anesthesia is administered and the patient is prepared for the operation, and it ends when the surgery is completed, the anesthesia is discontinued, and the patient is transferred to the recovery room or intensive care unit (ICU).

During the intraoperative period, the surgical team, including surgeons, anesthesiologists, nurses, and other healthcare professionals, work together to carry out the surgical procedure safely and effectively. The anesthesiologist monitors the patient's vital signs, such as heart rate, blood pressure, oxygen saturation, and body temperature, throughout the surgery to ensure that the patient remains stable and does not experience any complications.

The surgeon performs the operation, using various surgical techniques and instruments to achieve the desired outcome. The surgical team also takes measures to prevent infection, control bleeding, and manage pain during and after the surgery.

Overall, the intraoperative period is a critical phase of surgical treatment that requires close collaboration and communication among members of the healthcare team to ensure the best possible outcomes for the patient.

Endosonography, also known as endoscopic ultrasound (EUS), is a medical procedure that combines endoscopy and ultrasound to obtain detailed images and information about the digestive tract and surrounding organs. An endoscope, which is a flexible tube with a light and camera at its tip, is inserted through the mouth or rectum to reach the area of interest. A high-frequency ultrasound transducer at the tip of the endoscope generates sound waves that bounce off body tissues and create echoes, which are then translated into detailed images by a computer.

Endosonography allows doctors to visualize structures such as the esophageal, stomach, and intestinal walls, lymph nodes, blood vessels, and organs like the pancreas, liver, and gallbladder. It can help diagnose conditions such as tumors, inflammation, and infections, and it can also be used to guide biopsies or fine-needle aspirations of suspicious lesions.

Overall, endosonography is a valuable tool for the diagnosis and management of various gastrointestinal and related disorders.

Adenocarcinoma, papillary is a type of cancer that begins in the glandular cells and grows in a finger-like projection (called a papilla). This type of cancer can occur in various organs, including the lungs, pancreas, thyroid, and female reproductive system. The prognosis and treatment options for papillary adenocarcinoma depend on several factors, such as the location and stage of the tumor, as well as the patient's overall health. It is important to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan.

Obstructive Jaundice is a medical condition characterized by the yellowing of the skin, sclera (whites of the eyes), and mucous membranes due to the accumulation of bilirubin in the bloodstream. This occurs when there is an obstruction or blockage in the bile ducts that transport bile from the liver to the small intestine.

Bile, which contains bilirubin, aids in digestion and is usually released from the liver into the small intestine. When the flow of bile is obstructed, bilirubin builds up in the blood, causing jaundice. The obstruction can be caused by various factors, such as gallstones, tumors, or strictures in the bile ducts.

Obstructive jaundice may present with additional symptoms like dark urine, light-colored stools, itching, abdominal pain, and weight loss, depending on the cause and severity of the obstruction. It is essential to seek medical attention if jaundice is observed, as timely diagnosis and management can prevent potential complications, such as liver damage or infection.

Enteral nutrition refers to the delivery of nutrients to a person through a tube that is placed into the gastrointestinal tract, specifically into the stomach or small intestine. This type of nutrition is used when a person is unable to consume food or liquids by mouth due to various medical conditions such as swallowing difficulties, malabsorption, or gastrointestinal disorders.

Enteral nutrition can be provided through different types of feeding tubes, including nasogastric tubes, which are inserted through the nose and down into the stomach, and gastrostomy or jejunostomy tubes, which are placed directly into the stomach or small intestine through a surgical incision.

The nutrients provided through enteral nutrition may include commercially prepared formulas that contain a balance of carbohydrates, proteins, fats, vitamins, and minerals, or blenderized whole foods that are pureed and delivered through the feeding tube. The choice of formula or type of feed depends on the individual's nutritional needs, gastrointestinal function, and medical condition.

Enteral nutrition is a safe and effective way to provide nutrition support to people who are unable to meet their nutritional needs through oral intake alone. It can help prevent malnutrition, promote wound healing, improve immune function, and enhance overall health and quality of life.

"Low-volume hospitals" is a term used to describe healthcare facilities that have relatively few admissions or procedures for specific conditions or treatments within a given period. While there is no universally accepted threshold for what constitutes "low volume," some studies and guidelines define it as fewer than 100 cases per year for certain surgical procedures.

The significance of low-volume hospitals lies in the potential relationship between hospital volume and patient outcomes. Research has shown that, for many complex medical conditions and procedures, higher-volume hospitals often have better outcomes and lower complication rates compared to their lower-volume counterparts. This is thought to be due to several factors, including greater experience, specialized resources, and more efficient processes in high-volume hospitals.

However, it's essential to note that hospital volume is just one factor among many that can influence patient outcomes. Other elements, such as the quality of care, individual physician expertise, patient characteristics, and access to follow-up care, also play crucial roles in determining treatment success. Therefore, while low-volume hospitals may present additional challenges for specific procedures or conditions, they should not be automatically dismissed as suboptimal choices for all patients. Instead, a comprehensive evaluation of various factors is necessary when selecting the most appropriate healthcare facility for an individual's needs.

Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.

Bile ducts are tubular structures that carry bile from the liver to the gallbladder for storage or directly to the small intestine to aid in digestion. There are two types of bile ducts: intrahepatic and extrahepatic. Intrahepatic bile ducts are located within the liver and drain bile from liver cells, while extrahepatic bile ducts are outside the liver and include the common hepatic duct, cystic duct, and common bile duct. These ducts can become obstructed or inflamed, leading to various medical conditions such as cholestasis, cholecystitis, and gallstones.

Octreotide is a synthetic analogue of the natural hormone somatostatin, which is used in medical treatment. It is a octapeptide with similar effects to somatostatin, but with a longer duration of action. Octreotide is primarily used in the management of acromegaly, gastroenteropancreatic neuroendocrine tumors (GEP-NETs), and diarrhea and flushing associated with carcinoid syndrome.

It works by inhibiting the release of several hormones, including growth hormone, insulin, glucagon, and gastrin. This results in a decrease in symptoms caused by excessive hormone secretion, such as reduced growth hormone levels in acromegaly, decreased tumor size in some GEP-NETs, and improved diarrhea and flushing in carcinoid syndrome.

Octreotide is available in several forms, including short-acting subcutaneous injections (Sandostatin®), long-acting depot intramuscular injections (Sandostatin LAR®), and a slow-release formulation for the treatment of diarrhea associated with AIDS (Mycapssa™).

The medical definition of Octreotide is:

A synthetic octapeptide analogue of somatostatin, used in the management of acromegaly, gastroenteropancreatic neuroendocrine tumors (GEP-NETs), and diarrhea and flushing associated with carcinoid syndrome. Octreotide inhibits the release of several hormones, including growth hormone, insulin, glucagon, and gastrin, leading to symptomatic improvement in these conditions. It is available as short-acting subcutaneous injections, long-acting depot intramuscular injections, and a slow-release formulation for diarrhea associated with AIDS.

Surgical blood loss is the amount of blood that is lost during a surgical procedure. It can occur through various routes such as incisions, punctures or during the removal of organs or tissues. The amount of blood loss can vary widely depending on the type and complexity of the surgery being performed.

Surgical blood loss can be classified into three categories:

1. Insensible losses: These are small amounts of blood that are lost through the skin, respiratory tract, or gastrointestinal tract during surgery. They are not usually significant enough to cause any clinical effects.
2. Visible losses: These are larger amounts of blood that can be seen and measured directly during surgery. They may require transfusion or other interventions to prevent hypovolemia (low blood volume) and its complications.
3. Hidden losses: These are internal bleeding that cannot be easily seen or measured during surgery. They can occur in the abdominal cavity, retroperitoneal space, or other areas of the body. They may require further exploration or imaging studies to diagnose and manage.

Surgical blood loss can lead to several complications such as hypovolemia, anemia, coagulopathy (disorders of blood clotting), and organ dysfunction. Therefore, it is essential to monitor and manage surgical blood loss effectively to ensure optimal patient outcomes.

The Chi-square distribution is a continuous probability distribution that is often used in statistical hypothesis testing. It is the distribution of a sum of squares of k independent standard normal random variables. The resulting quantity follows a chi-square distribution with k degrees of freedom, denoted as χ²(k).

The probability density function (pdf) of the Chi-square distribution with k degrees of freedom is given by:

f(x; k) = (1/ (2^(k/2) * Γ(k/2))) \* x^((k/2)-1) \* e^(-x/2), for x > 0 and 0, otherwise.

Where Γ(k/2) is the gamma function evaluated at k/2. The mean and variance of a Chi-square distribution with k degrees of freedom are k and 2k, respectively.

The Chi-square distribution has various applications in statistical inference, including testing goodness-of-fit, homogeneity of variances, and independence in contingency tables.

Reconstructive surgical procedures are a type of surgery aimed at restoring the form and function of body parts that are defective or damaged due to various reasons such as congenital abnormalities, trauma, infection, tumors, or disease. These procedures can involve the transfer of tissue from one part of the body to another, manipulation of bones, muscles, and tendons, or use of prosthetic materials to reconstruct the affected area. The goal is to improve both the physical appearance and functionality of the body part, thereby enhancing the patient's quality of life. Examples include breast reconstruction after mastectomy, cleft lip and palate repair, and treatment of severe burns.

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In severe cases of pancreaticoduodenal injury, a pancreaticoduodenectomy can be used. Common complications after surgery ...
Pancreaticoduodenectomy is the surgical removal involving the pancreas and the duodenum. Panniculectomy is the removal of a ...
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Laparoscopic pancreaticoduodenectomy for Duodenal GIST. Jia-Yu Zhou, MD1, Wei-Wei Jin, MD1, Yi-Ping Mou, MD2, Xiao-Wu Xu, MD2, ... The aim of this study is to describe perioperative and follow-up outcomes of laparoscopic pancreaticoduodenectomy (LPD) for ... Laparoscopic pancreaticoduodenectomy is a safe, feasible and effective surgical procedure for duodenal GIST. ...
Keywords: Pancreaticojejunal anastomosis, Pancreatic fistula, Pancreaticoduodenectomy Core tip: Pancreaticoduodenectomy is a ... Application of single-layer mucosa-to-mucosa pancreaticojejunal anastomosis in pancreaticoduodenectomy Bing-Yang Hu, Jian-Jun ... METHODS: A retrospective analysis was performed on the data of patients who received pancreaticoduodenectomy completed by the ... Pancreaticojejunal anastomosis plays an important role in pancreaticoduodenectomy; its success determines the success of the ...
We performed pancreaticoduodenectomy using the “artery-first” approach. ,i,Discussion,/i,. Both annular pancreas ... i,Conclusion,/i,. The “artery-first” approach may be a useful method for pancreaticoduodenectomy in patients who ... We performed pancreaticoduodenectomy using the "artery-first" approach. Discussion. Both annular pancreas and common hepatic ... Pancreaticoduodenectomy for an Ampullary Region Carcinoma Occurred in Annular Pancreas Coexistent with Replaced Common Hepatic ...
Laparoscopy-Assisted versus Open Pancreaticoduodenectomy: A Comparative Study in an Early Canadian Experience. Yifan Wang, ... LAPD combines the superior ergonomics and visualization of open pancreaticoduodenectomy (OPD) with the benefits of a minimally ... To obviate this limitation, we performed laparoscopy-assisted pancreaticoduodenectomy (LAPD): a hybrid laparoscopic-open ... Introduction: Despite advances in minimally invasive surgery, the implementation of total laparoscopic pancreaticoduodenectomy ...
Fatal arterial hemorrhage after pancreaticoduodenectomy: How do we simultaneously accomplish complete hemostasis and hepatic ... Core Tip: Arterial hemorrhage after pancreaticoduodenectomy is fatal. This hemorrhage is caused by pseudoaneurysm rupture, and ... Fatal arterial hemorrhage after pancreaticoduodenectomy: How do we simultaneously accomplish complete hemostasis and hepatic ... Fatal arterial hemorrhage after pancreaticoduodenectomy: How do we simultaneously accomplish complete hemostasis and hepatic ...
... but the role of laparoscopic pancreaticoduodenectomy is still controversial. Laparoscopic pancreaticoduodenectomyhas seldom ... Laparoscopic pancreaticoduodenectomy for ductal adenocarcinoma of common bileduct: A case report and literature review. Med Sci ...
Quality of life and outcomes after pancreaticoduodenectomy. Ann Surg 2000;231:890-8.doi:10.1097/00000658-200006000-00014pmid: ... Health is belonging: lived experiences during recovery after pancreaticoduodenectomy. ISRN Nurs 2012;2012:602323 doi:10.5402/ ... A PAG was convened with patients who had undergone a pancreaticoduodenectomy more than 6 years previously and were thus ... Preoperative factors predict perioperative morbidity and mortality after pancreaticoduodenectomy. Ann Surg Oncol 2011;18:2126- ...
Pancreaticoduodenectomy (PD) nowadays serves as a standard treatment for patients with disorders of the pancreas, intestine, ... Pancreaticoduodenectomy (PD)-also known as a Whipple procedure-is a complex operation that is used to treat tumors and other ... Pancreaticoduodenectomy (PD) nowadays serves as a standard treatment for patients with disorders of the pancreas, intestine, ... Machine learning algorithms as early diagnostic tools for pancreatic fistula following pancreaticoduodenectomy and guide drain ...
... is also known as Whipples procedure. For tumours, staging for loco-regional spread & distant ... Pancreaticoduodenectomy is also known as Whipples procedure.. Preoperative Preparation. *For tumours, staging for loco- ...
Whipple procedure (pancreaticoduodenectomy). A Whipple procedure is used to treat pancreatic NETs found in the head of the ... pancreaticoduodenectomy), and total pancreatectomy. The type of surgery needed depends on several factors, including the ...
Objective The aim of this study was to evaluate pre-operative factors predicting a short survival after pancreatico-duodenectomy ... Size and Diabetes Are the Most Important Pre-Operative Prognostic Factors Influencing Survival After Pancreaticoduodenectomy in ... Size and Diabetes Are the Most Important Pre-Operative Prognostic Factors Influencing Survival After Pancreaticoduodenectomy in ...
Pancreaticoduodenectomy. Surgical excision remains the mainstay of treatment of adenocarcinomas of the main duodenal papilla in ... Laparoscopic pancreaticoduodenectomy: technique and outcomes. J Am Coll Surg. 2007 Aug. 205(2):222-30. [QxMD MEDLINE Link]. ... If the tumor is deemed resectable, the operation of choice is a pancreaticoduodenectomy. [46] Although the Whipple version has ... Kim et al reported that the predictors of failure after pancreaticoduodenectomy were the staging of disease and nodal status. [ ...
... Buscemi, Salvatore. ;DAMIANO, Giuseppe;PALUMBO, Vincenzo ... Pancreaticoduodenectomy (PD) is considered the gold standard treatment for periampullory carcinomas. This procedure presents 30 ... Pancreaticoduodenectomy (PD) is considered the gold standard treatment for periampullory carcinomas. This procedure presents 30 ... Patients who have undergone pancreaticoduodenectomy often present perioperative malnutrition that is worse in the early ...
Surgical Site Infections Following Pancreaticoduodenectomy. / Burkhart, Richard A.; Weiss, Matthew J. In: HPB, Vol. 19, No. 12 ... Burkhart, RA & Weiss, MJ 2017, Surgical Site Infections Following Pancreaticoduodenectomy, HPB, vol. 19, no. 12, pp. 1131. ... Burkhart, Richard A. ; Weiss, Matthew J. / Surgical Site Infections Following Pancreaticoduodenectomy. In: HPB. 2017 ; Vol. 19 ... Surgical Site Infections Following Pancreaticoduodenectomy. HPB. 2017 Dec;19(12):1131. doi: 10.1016/j.hpb.2017.08.006 ...
Pancreaticoduodenectomy has evolved since Kausch performed the first successful procedure as a two-stage operation in 1912. ... Background Some background information regarding pylorus-preserving pancreaticoduodenectomy (PPPD), also commonly referred to ... Pylorus-Preserving Pancreaticoduodenectomy (Whipple Procedure) * Sections Pylorus-Preserving Pancreaticoduodenectomy (Whipple ... Pylorus-preserving pancreaticoduodenectomy (pp Whipple) versus pancreaticoduodenectomy (classic Whipple) for surgical treatment ...
We aimed to compare the safety and effectiveness of the following procedures after pancreaticoduodenectomy: isolated ... and conventional pancreaticojejunostomy after pancreaticoduodenectomy: a systematic review and meta-analysis ...
Lee, D. Y., Schwartz, J. A., Wexelman, B., Kirchoff, D., Yang, K. C., & Attiyeh, F. (2014). Outcomes of pancreaticoduodenectomy ... T1 - Outcomes of pancreaticoduodenectomy for pancreatic malignancy in octogenarians. T2 - An American College of Surgeons ... Lee, DY, Schwartz, JA, Wexelman, B, Kirchoff, D, Yang, KC & Attiyeh, F 2014, Outcomes of pancreaticoduodenectomy for ... Outcomes of pancreaticoduodenectomy for pancreatic malignancy in octogenarians: An American College of Surgeons National ...
Aim: Pancreaticoduodenectomy is a challenging procedure used primarily for the treatment of pancreatic head cancers. The aim of ... Initial operative experience with pancreaticoduodenectomy after fellowship training. Oktay Karaköse,Servet Karagül,Fikri Arslan ... Material and Methods: Patients who underwent pancreaticoduodenectomy by the same surgical team between November 2015 and August ... Conclusion: Our experience demonstrates that pancreaticoduodenectomy can be performed with acceptable outcomes after fellowship ...
Methods: This prospective study was conducted on all patients (n=40) who underwent pancreaticoduodenectomy in Attikon ... Conclusions: Quality of Life levels among patients who undergo pancreaticoduodenectomy are getting worse following surgery. ... Comparison of Quality of Life before and after pancreaticoduodenectomy: a prospective study ... The aim of the study was to determine perceived Quality of Life levels among patients who undergo pancreaticoduodenectomy, in a ...
Methods: Patients who underwent pancreaticoduodenectomy between 2018 and 2022 were divided into 3 groups: those who received no ... Is Immunonutrition Effective on Surgical Site Infection and Length of Hospital Stay in Pancreaticoduodenectomy Patients?. ... Conclusion: In malnourished or at risk of malnutrition patients undergoing pancreaticoduodenectomy for periampullary site ... Is immunonutrition effective on surgical site infection and length of hospital stay in pancreaticoduod enectomy patients? Clin ...
Pancreaticoduodenectomy; Whipple procedure; Open distal pancreatectomy and splenectomy; Laparoscopic distal pancreatectomy; ...
Choi, M., Hwang, H. K., Rho, S. Y., Lee, W. J., & Kang, C. M. (2020). Comparing laparoscopic and open pancreaticoduodenectomy ... Choi, M, Hwang, HK, Rho, SY, Lee, WJ & Kang, CM 2020, Comparing laparoscopic and open pancreaticoduodenectomy in patients with ... We evaluated the oncologic benefit of LPD and compared the inflammatory score between LPD and open pancreaticoduodenectomy (OPD ... We evaluated the oncologic benefit of LPD and compared the inflammatory score between LPD and open pancreaticoduodenectomy (OPD ...
Please review SCOREs TWIS module on Pancreaticoduodenectomy (https://www.surgicalcore.org/modulecontent.aspx?id=145049) ...
Incidence and risk factors of postoperative acute pancreatitis after pancreaticoduodenectomy: a systematic review and meta- ... Datasheet1_Incidence and risk factors of postoperative acute pancreatitis after pancreaticoduodenectomy: a systematic review ... Datasheet1_Incidence and risk factors of postoperative acute pancreatitis after pancreaticoduodenectomy: a systematic review ... systematic reviews or meta-analytic studies have assessed the incidence and risk factors of POAP after pancreaticoduodenectomy ...
Background: According to international guidelines, artificial nutrition may be indicated after pancreaticoduodenectomy (PD). ...
Wound Infections After Pancreaticoduodenectomy.﻽. Schoeniger LO, Linehan DC. JAMA surgery.. 2016 May 1151 (5):440. Epub 1900 01 ... Pancreaticoduodenectomy in the Presence of SMV Obstruction,. Koniaris, LG; Staveley-OCarroll, KF; Zeh, HJ; Perez, E; Jin, X; ... Early Prediction of Length of Stay After Pancreaticoduodenectomy.﻽. Pineda-Solis K, Burchard PR, Ruffolo LI, Schoeniger LO, ... Intrathecal Morphine and Effect on Opioid Consumption and Functional Recovery after Pancreaticoduodenectomy.﻽. Burchard PR, ...
Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? ... Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? ... Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? ... Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? ...
... lymphocyte ratio in predicting pancreatic fistula in patients undergoing pancreaticoduodenectomy for periampullary tumors ... lymphocyte ratio in predicting pancreatic fistula in patients undergoing pancreaticoduodenectomy for periampullary tumors . ...
  • Material and Methods: Patients who underwent pancreaticoduodenectomy by the same surgical team between November 2015 and August 2018 were retrospectively analyzed. (bibliomed.org)
  • This prospective study was conducted on all patients (n=40) who underwent pancreaticoduodenectomy in Attikon University General Hospital in Athens, Greece, from January 2013 to June 2015. (ephysician.ir)
  • Patients who underwent pancreaticoduodenectomy between 2018 and 2022 were divided into 3 groups: those who received no nutritional support, those who received standard nutritional support, and those who received immunonutrition. (clinscinutr.org)
  • Results: Two hundred eleven patients underwent pancreaticoduodenectomy with pancreatic-enteric anastomosis, received appropriate saline/octreotide doses, and were available for endpoint analysis. (arizona.edu)
  • Methods Retrospective single center cohort study of patients who underwent pancreaticoduodenectomy over the past 10 years for carcinoma obstructing the lower common bile duct. (thieme-connect.de)
  • Patients who underwent biliary stenting alone, biliary and pancreatic stenting, and no stenting prior to pancreaticoduodenectomy were the three study cohort groups and their records were scrutinized for the incidence of postoperative pancreatic fistula. (thieme-connect.de)
  • Of 1789 patients who had pancreatic cysts, 104 underwent surgical intervention, which for approximately one third was pancreaticoduodenectomy and for the other two thirds was distal pancreatectomy. (medscape.com)
  • LAPD combines the superior ergonomics and visualization of open pancreaticoduodenectomy (OPD) with the benefits of a minimally invasive approach. (sages.org)
  • We evaluated the oncologic benefit of LPD and compared the inflammatory score between LPD and open pancreaticoduodenectomy (OPD). (elsevierpure.com)
  • The aim of this study is to describe perioperative and follow-up outcomes of laparoscopic pancreaticoduodenectomy (LPD) for Duodenal GIST. (sages.org)
  • Laparoscopic pancreaticoduodenectomy is a safe, feasible and effective surgical procedure for duodenal GIST. (sages.org)
  • Despite advances in minimally invasive surgery, the implementation of total laparoscopic pancreaticoduodenectomy (TLPD) remains controversial. (sages.org)
  • Laparoscopic pancreaticoduodenectomy for ductal adenocarcinoma of common bileduct: A case report and literature review. (medscimonit.com)
  • Background: Both the technical and oncological safety of laparoscopic pancreaticoduodenectomy (LPD) remain controversial in treating pancreatic head cancer. (elsevierpure.com)
  • Post-operative death and complications associated with pancreaticoduodenectomy have become less common, with rates of post-operative mortality falling from 10 to 30% in the 1980s to less than 5% in the 2000s. (wikipedia.org)
  • Patients who have undergone pancreaticoduodenectomy often present perioperative malnutrition that is worse in the early postoperative days, affects the process of healing, the intestinal barrier function and the number of postoperative complications. (unipa.it)
  • Few studies focus on the relation between enteral nutrition (EN) and postoperative complications. (unipa.it)
  • Our aim was to perform a review, including only randomized controlled trial meta-analyses or well-designed studies, of evidence regarding the correlation between EN and main complications and outcomes after pancreaticoduodenectomy, as delayed gastric emptying (DGE), postoperative pancreatic fistula (POPF), postpancreatectomy hemorrhage (PPH), length of stay and infectious complications. (unipa.it)
  • EN appeared safe and tolerated for patients after PD, even if it did not reveal any advantages in terms of POPF, PPH, length of stay and infectious complications. (unipa.it)
  • Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? (arizona.edu)
  • Objective: To evaluate the endpoints of complications (specifically pancreatic fistula and total complications) and death in patients undergoing pancreaticoduodenectomy. (arizona.edu)
  • Conclusions: These data demonstrate that the prophylactic use of perioperative octreotide does not reduce the incidence of pancreatic fistula or total complications after pancreaticoduodenectomy. (arizona.edu)
  • Dive into the research topics of 'Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? (arizona.edu)
  • Background Surgeons and endoscopists welcome routine preoperative biliary drainage prior to pancreaticoduodenectomy despite evidence that it increases complications. (thieme-connect.de)
  • As advances in medicine yielded better perioperative outcomes across surgical applications, interest in the Whipple procedure was revitalized, and pancreaticoduodenectomy was performed increasingly often. (medscape.com)
  • Background Most series analyzing outcomes of pancreaticoduodenectomy in octogenarians are limited by a small sample size. (mssm.edu)
  • The aim of this study was to share early outcomes of the first pancreaticoduodenectomy operations performed by our surgery team after completing a gastroenterological surgery and surgical oncology fellowship program. (bibliomed.org)
  • Conclusion: Our experience demonstrates that pancreaticoduodenectomy can be performed with acceptable outcomes after fellowship training that includes pancreatic surgery. (bibliomed.org)
  • Background: To better characterize short-term and long-term outcomes in children with pancreatic tumors treated with pancreaticoduodenectomy (PD). (elsevierpure.com)
  • In malnourished or at risk of malnutrition patients undergoing pancreaticoduodenectomy for periampullary site malignancy, nutritional support positively affects the development of surgical site infection, whereas specifically, immunonutrition does not reduce postoperative surgical site infection or length of hospital stay. (clinscinutr.org)
  • Pancreaticoduodenectomy Among Patients With Pancreatic Ductal Adenocarcinoma. (cancercentrum.se)
  • Other indications for pancreaticoduodenectomy include chronic pancreatitis, benign tumors of the pancreas, cancer metastatic to the pancreas, multiple endocrine neoplasia type 1 and gastrointestinal stromal tumors. (wikipedia.org)
  • In 1937, Brunschwig extended the indications for pancreaticoduodenectomy by performing the operation for pancreatic head lesions. (medscape.com)
  • There Is No Increase in Perioperative Mortality After Pancreaticoduodenectomy in Octogenarians: Results From the Swedish National Registry for Tumors in the Pancreatic and Periampullary Region. (cancercentrum.se)
  • Objectives Ten per cent of patients diagnosed with pancreatic cancer undergo pancreaticoduodenectomy. (bmj.com)
  • Objective: The aim of the study was to determine perceived Quality of Life levels among patients who undergo pancreaticoduodenectomy, in a period of six months after surgery. (ephysician.ir)
  • Quality of Life levels among patients who undergo pancreaticoduodenectomy are getting worse following surgery. (ephysician.ir)
  • Design Inductive qualitative study involving in-depth semistructured interviews with 20 participants who had undergone pancreaticoduodenectomy for pancreatic or distal biliary duct cancer. (bmj.com)
  • Pancreaticoduodenectomy is the only potentially curative intervention for malignant tumors of the pancreas. (wikipedia.org)
  • Pancreaticoduodenectomy (PD)-also known as a Whipple procedure-is a complex operation that is used to treat tumors and other disorders of the pancreas, intestine, and bile duct. (biomedcentral.com)
  • A pancreaticoduodenectomy, also known as a Whipple procedure, is a major surgical operation most often performed to remove cancerous tumours from the head of the pancreas. (wikipedia.org)
  • Some background information regarding pylorus-preserving pancreaticoduodenectomy (PPPD), also commonly referred to as the Whipple procedure, is provided below. (medscape.com)
  • This report shows a reduced morbidity and a clear survival advantage for patients undergoing pancreaticoduodenectomy (Whipple procedure) at a high-volume center. (medscape.com)
  • Pancreaticoduodenectomy (PD) is a procedure associated with significant morbidity and mortality . (bvsalud.org)
  • Morbidity and mortality of pancreaticoduodenectomy for benign and premalignant pancreatic neoplasms. (umassmed.edu)
  • To investigate the simplicity, reliability, and safety of the application of single-layer mucosa-to-mucosa pancreaticojejunal anastomosis in pancreaticoduodenectomy. (wjgnet.com)
  • Although innumerable details of pancreaticoduodenectomy yield to continued innovation, a comprehensive discussion of intraoperative variants (ie, duct to mucosa vs invagination of the pancreaticojejunal anastomosis, diverse approaches to vein reconstructions, nuances of each enteric anastomosis, and modifications of Roux-en-Y reconstructions, to name a few) is beyond the scope of this article. (medscape.com)
  • A retrospective analysis was performed on the data of patients who received pancreaticoduodenectomy completed by the same surgical group between January 2011 and April 2014 in the General Hospital of the People's Liberation Army. (wjgnet.com)
  • Pancreatic cancer is an aggressive malignancy, and surgical resection is the only therapeutic option with pancreaticoduodenectomy being considered the standard of care. (ephysician.ir)
  • Is Immunonutrition Effective on Surgical Site Infection and Length of Hospital Stay in Pancreaticoduodenectomy Patients? (clinscinutr.org)
  • In this study, we evaluated the effect of standard nutritional support and immunonutrition on surgical site infection and postoperative length of hospital stay in patients undergoing pancreaticoduodenectomy for malignancy. (clinscinutr.org)
  • Operative management of portal annular pancreas during pancreaticoduodenectomy. (doximity.com)
  • Contemporary review of minimally invasive pancreaticoduodenectomy. (wjgnet.com)
  • Jianhua Yu, L. Wu and B. Li, Meta-analysis of pancreaticogastrostomy versus pancreaticojejunostomy on occurrences of postoperative pancreatic fistula after pancreaticoduodenectomy, Asian Journal of Surgery (2015). (scipedia.com)
  • Modified pancreaticogastrostomy following pancreaticoduodenectomy. (nih.gov)
  • Important subsequent advances included the application of new technologies (ie, laparoscopic and robotic approaches to pancreaticoduodenectomy). (medscape.com)
  • The effect of preoperative biliary drainage (PBD) prior to pancreaticoduodenectomy (PD) on postoperative pancreatic fistula (POPF) is variably reported in literature. (thieme-connect.de)
  • The most common technique of a pancreaticoduodenectomy consists of the en bloc removal of the distal segment (antrum) of the stomach, the first and second portions of the duodenum, the head of the pancreas, the common bile duct, and the gallbladder. (wikipedia.org)
  • Participants Patients were eligible for inclusion if they had had pancreaticoduodenectomy for head of pancreas cancer, periampullary cancer or distal cholangiocarcinoma between 6 months and 6 years previously, and had completed adjuvant chemotherapy. (bmj.com)
  • Aim: Pancreaticoduodenectomy is a challenging procedure used primarily for the treatment of pancreatic head cancers. (bibliomed.org)
  • Pancreaticoduodenectomy is most often performed as curative treatment for periampullary cancer, which include cancer of the bile duct, duodenum, ampulla or head of the pancreas. (wikipedia.org)
  • The shared blood supply of the pancreas, duodenum and common bile duct necessitates en bloc resection of these multiple structures. (wikipedia.org)
  • Pancreaticoduodenectomy (PD) nowadays serves as a standard treatment for patients with disorders of the pancreas, intestine, and bile duct. (biomedcentral.com)
  • In 1946, Waugh and Clagett described a formal en-bloc resection of the gallbladder with the common bile duct (CBD), gastric antrum, duodenum, and head of pancreas performed as a one-stage procedure, which we recognize today as the classic pancreaticoduodenectomy. (medscape.com)
  • Pancreaticoduodenectomy is also known as Whipple's procedure . (msurgery.ie)
  • Pancreaticoduodenectomy has evolved since Kausch performed the first successful procedure as a two-stage operation in 1912. (medscape.com)
  • However, not all lymph nodes are removed in the most common type of pancreaticoduodenectomy because studies showed that patients did not benefit from the more extensive surgery. (wikipedia.org)
  • This paper reports the psychological impact of a pancreatic cancer diagnosis and subsequent pancreaticoduodenectomy, exploring how patients' lives alter following surgery and how they seek support. (bmj.com)
  • However, to the best of our knowledge, no systematic reviews or meta-analytic studies have assessed the incidence and risk factors of POAP after pancreaticoduodenectomy (PD). (figshare.com)
  • Pancreaticoduodenectomy (PD) is considered the gold standard treatment for periampullory carcinomas. (unipa.it)
  • The modern colloquial name for this operation refers to Dr Allen Oldfather Whipple, the surgeon who reported his series of pancreaticoduodenectomies in 1935. (medscape.com)
  • We believe that this is the first qualitative study using semistructured interviews to explore the psychological impact of living with and after pancreaticoduodenectomy. (bmj.com)
  • Pancreatic fistula (PF) is the most common and challenging complication after pancreaticoduodenectomy (PD). (scipedia.com)
  • The main analysis was restricted to patients undergoing a pancreaticoduodenectomy at either a local facility performing fewer than 3.3 operations per year (n = 773) or a distant center performing greater than 16 procedures per year (n = 758). (medscape.com)
  • Intrathecal Morphine and Effect on Opioid Consumption and Functional Recovery after Pancreaticoduodenectomy. (rochester.edu)