Surgical Results of Pancreatoduodenectomy for Disease in the Pancreatic Head Region

1997 ◽  
pp. 93-98 ◽  
Author(s):  
Toshimichi Nakayama ◽  
Hisafumi Kinoshita ◽  
Hideki Saitsu ◽  
Hiroyasu Imayama ◽  
Kouji Okuda ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
Surgical Results ◽  
Head Region

RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH CHRONIC PANCREATITIS AND THE RISK OF CANCER AFTER SURGICAL TREATMENT

2018 ◽  
Vol 64 (2) ◽  
pp. 228-233
Author(s):  
Vladimir Lubyanskiy ◽  
Vasiliy Seroshtanov ◽  
Ye. Semenova
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Fibrous Tissue ◽  
Pancreatic Head ◽  
Head Region ◽  
Intestinal Anastomoses ◽  
Resection Of The Pancreas ◽  
Risk Of Cancer

The aim: To analyze results of surgical treatment of patients with chronic pancreatitis (CP) and to assess the causes of pancreatic cancer after surgical treatment. Materials and methods: 137 patients had duodenum-preserving resections of the pancreas. Results: In the histological examination of the pancreas it was established that the growth of fibrous tissue was registered in patients with CP., which in 19 (13.8%) almost completely replaced the acinar tissue. In the long term after the operation from 6 months to 2 years in 8 patients (5.8%) pancreatic cancer was detected. Possible causes of tumor origin were analyzed, the value of preservation of ductal hypertension, which affects the state of the duct’s epithelium, was established. The most commonly used for treatment of chronic pancreatitis the Frey surgery removed pancreatic hypertension but in two patients during the operation an insufficient volume of the pancreatic head was reconstructed. In the case of the abandonment of a large array of fibrous tissue, local hypertension was retained in the region of the ductal structures of the head, which led to the transformation of the duct epithelium. An essential factor in the problem of the preservation of pancreatic hypertension were the stenosis of pancreatic intestinal anastomoses, they arose in the long term in 4 operated patients. With stenosis of anastomosis after duodenum-preserving resection both the hypertension factor and the regeneration factor could be realized, which under certain circumstances might be significant. Conclusion: After resection of the pancreas for CP cancer was diagnosed in 5.8% of patients. The main method of preventing the risk of cancer was performing the Frey surgery for CP eliminating pancreatic hypertension in the head region of the pancreas. Diagnosis of stenosis in the late period after resection of the pancreas was an important element in the prevention of recurrence of cancer since a timely reconstructive operation could improve the drainage of duct structures.

scholarly journals Placebo controlled trial of enteric coated pancreatin microsphere treatment in patients with unresectable cancer of the pancreatic head region

Gut ◽  
1998 ◽  
Vol 42 (1) ◽  
pp. 92-96 ◽  
Author(s):  
M J Bruno ◽  
E B Haverkort ◽  
G P Tijssen ◽  
G N J Tytgat ◽  
D J van Leeuwen
Keyword(s):  
Weight Loss ◽  
Confidence Interval ◽  
Pancreatic Duct ◽  
Pancreatic Head ◽  
Pancreatic Enzymes ◽  
High Dose ◽  
Head Region ◽  
Biliary Endoprosthesis ◽  
The Difference ◽  
Enteric Coated

Background—Impeded flow of pancreatic juice due to mechanical obstruction of the pancreatic duct in patients with cancer of the pancreatic head region causes exocrine pancreatic insufficiency with steatorrhoea and creatorrhoea. This may contribute to the profound weight loss that often occurs in these patients.Aims—To investigate whether pancreatic enzyme replacement therapy prevents this weight loss.Patients—Twenty one patients with unresectable cancer of the pancreatic head region with suspected pancreatic duct obstruction, a biliary endoprosthesis in situ, and a Karnofsky performance status greater than 60.Methods—Randomised double blind trial of eight weeks with either placebo or high dose enteric coated pancreatin enzyme supplementation. All patients received dietary counselling.Results—The mean difference in the percentage change of body weight was 4.9% (p=0.02, 95% confidence interval for the difference: 0.9 to 8.9). Patients on pancreatic enzymes gained 1.2% (0.7 kg) body weight whereas patients on placebo lost 3.7% (2.2 kg). The fat absorption coefficient in patients on pancreatic enzymes improved by 12% whereas in placebo patients it dropped by 8% (p=0.13, 95% confidence interval for the difference: –6 to 45). The daily total energy intake was 8.42 MJ in patients on pancreatic enzymes and 6.66 MJ in placebo patients (p=0.04, 95% confidence interval for the difference: 0.08 to 3.44).Conclusions—Weight loss in patients with unresectable cancer of the pancreatic head region and occlusion of the pancreatic duct can be prevented, at least for the period immediately after insertion of a biliary endoprosthesis, by high dose enteric coated pancreatin enzyme supplementation in combination with dietary counselling.

Extrapancreatic neural plexus invasion by carcinomas of the pancreatic head region: evaluation using thin-section helical CT

2007 ◽  
Vol 25 (4) ◽  
pp. 141-147 ◽  
Author(s):  
Hui Tian ◽  
Hiromu Mori ◽  
Shunro Matsumoto ◽  
Yasunari Yamada ◽  
Hiro Kiyosue ◽  
...  
Keyword(s):  
Thin Section ◽  
Pancreatic Head ◽  
Helical Ct ◽  
Head Region ◽  
Plexus Invasion

scholarly journals Isolated pancreatic tuberculosis presenting as obstructive jaundice

2021 ◽  
Vol 8 (4) ◽  
pp. 1296
Author(s):  
Muhammad Salman Shafique ◽  
Sayyam Fatima
Keyword(s):  
Obstructive Jaundice ◽  
Pancreatic Head ◽  
Needle Aspiration ◽  
Tuberculosis Patient ◽  
Head Region ◽  
Gradual Improvement ◽  
Pancreatic Tuberculosis ◽  
History Of ◽  
Diagnostic Work ◽  
Anti Tubercular Therapy

A 36-year-old male patient presented in surgical clinic with complaints of abdominal pain and progressively increasing yellowish discoloration of his skin and sclera for last 1 month. He was deeply jaundiced with mild tenderness in epigastric region. He had a strong family history of tuberculosis. Diagnostic work-up revealed obstructive jaundice secondary to pancreatic tuberculosis. Tomographic examination revealed a pancreatic head mass with peripancreatic lymphadenopathy. Endoscopic ultrasound (EUS) showed a mass at pancreatic head region & EUS guided fine needle aspiration revealed tuberculosis. Patient was started on anti-tubercular therapy with gradual improvement of symptoms over the course of treatment.

scholarly journals Primary retroperitoneal hydatid cyst in pancreatic head region

2020 ◽  
Vol 4 (8) ◽  
pp. 1-1
Author(s):  
Shilpi KARMAKAR ◽  
Sanjay KALA ◽  
Saurabh KARMAKAR
Keyword(s):  
Hydatid Cyst ◽  
Pancreatic Head ◽  
Head Region ◽  
Primary Retroperitoneal

scholarly journals Prognostic value of p27kip1 expression in adenocarcinoma of the pancreatic head region

HPB ◽  
2006 ◽  
Vol 8 (3) ◽  
pp. 216-222 ◽  
Author(s):  
Jerzy Mielko ◽  
Wojciech P. Polkowski ◽  
Danuta G. Skomra ◽  
Andrzej J. Stanisławek ◽  
Andrzej M. Kurylcio ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Pancreatic Head ◽  
Head Region ◽  
P27kip1 Expression

Transhepatic intravascular ultrasound for evaluation of portal venous involvement in patients with cancer of the pancreatic head region

2001 ◽  
Vol 12 (5) ◽  
pp. 1150-1154 ◽  
Author(s):  
P. Hannesson ◽  
C. Lundstedt ◽  
S. Dawiskiba ◽  
H. Stridbeck ◽  
I. Ihse
Keyword(s):  
Intravascular Ultrasound ◽  
Pancreatic Head ◽  
Head Region ◽  
Venous Involvement ◽  
Patients With Cancer

scholarly journals Extensive Dissection of Lymph Nodes and Nerve Plexus for Carcinoma of the Pancreatic Head Region.

1995 ◽  
Vol 28 (4) ◽  
pp. 898-902
Author(s):  
Akimasa Nakao ◽  
Akio Harada ◽  
Toshiaki Nomami ◽  
Tetsuya Kaneko ◽  
Shin Takeda ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Pancreatic Head ◽  
Nerve Plexus ◽  
Head Region

scholarly journals CLINICOPATHOLOGICAL STUDY OF RECURRENT CASES AFTER CURATIVE RESECTION IN CARCINOMAS OF PANCREATIC HEAD REGION

1993 ◽  
Vol 54 (9) ◽  
pp. 2261-2266
Author(s):  
Takashi KAMIGAKI ◽  
Tetsuo AJIKI ◽  
Tomoki TABATA ◽  
Osamu OHASHI ◽  
Hirohiko ONOYAMA ◽  
...  
Keyword(s):  
Curative Resection ◽  
Pancreatic Head ◽  
Head Region ◽  
Clinicopathological Study

Duodenum-Preserving Pancreatic Head Resection: Future Standard Operation in Chronic Pancreatitis

Swiss Surgery ◽  
2000 ◽  
Vol 6 (5) ◽  
pp. 254-258 ◽  
Author(s):  
Kondo ◽  
Friess ◽  
Tempia-Caliera ◽  
Büchler
Keyword(s):  
Chronic Pancreatitis ◽  
Pain Relief ◽  
Extrahepatic Bile Duct ◽  
Pancreatic Head ◽  
Operative Therapy ◽  
Long Term Results ◽  
Pancreatic Head Resection ◽  
Head Region ◽  
Standard Operation

As the incidence of chronic pancreatitis (CP) has risen in most industrialized countries due to increasing alcohol intake, operative therapy has gained importance, and various new operative procedures have been introduced in the past two or three decades. With pancreatic duct drainage operations, pain relief is frequently not satisfactory in long-term follow-up. Pathological studies in combination with modern molecular biology investigations, suggests that the pancreatic head is the "pacemaker" of the disease in most CP patients. Therefore, surgical procedures which aim to remove pancreatic head-related CP complications are needed in most patients. The Whipple operation, which was originally developed to treat malignancies in the pancreatic head region, follows oncological criteria and can therefore be considered surgical overtreatment in the majority of CP patients. As an alternative, the duodenum-preserving pancreatic head resection (DPPHR) was introduced by Hans Beger in 1972 to preserve the stomach, the extrahepatic bile duct and the duodenum. DPPHR is an organ-preserving surgical procedure which provides satisfactory long-term results with regard to mortality, morbidity, pain relief, weight gain and social and professional rehabilitation. Among the operations currently available, DPPHR is the best choice for a new standard operation in patients with pancreatic head-related complications.

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