Cephalic Duodeno-Pancreatectomy with Pancreatic-Gastric Anastomosis with Double Purse String, in Patient with Lithiasis and Tumoral Jaundice - Case Report

Abstract Introduction: One of the most feared complications after cephalic duodeno-pancreatectomy remains pancreatic fistula. In recent years, various methods of pancreatico-digestive reconstruction were performed in order to reduce the rate of pancreatic fistula. One of these methods is pancreatico-gastric reconstruction by using two purse string threads. Case report: We present in this article a patient with jaundice with mixed etiology: tumoral and lithiasic. Subjectively, the patient accused sclerose-skin-jaundice, right upper quadrant and epigastric pain, nausea and vomiting. Computed tomography revealed dilatation of intraand extrahepatic bile ducts, a dilated Wirsung duct and a tumor at the biliopancreatic confluence, leading to a suspicion of vaterian ampulom. Upper endoscopy revealed a tumor protruding in the descending duodenal segment. Intraoperatively a tumor suggestive of vaterian ampulom and duct stones was shown. Surgical treatment consisted of coledocolitotomy, cephalic duodeno-pancreatectomy with pancreatic-gastric anastomosis, performed by using two purse string threads. The postoperative evolution was favorable. Conclusion: Pancreatico-gastric anastomosis using two purse string threads is a simple, safe and quick procedure, avoiding the application of sutures through the pancreatic parenchyma and thus reducing the rate of pancreatic fistula.

Download Full-text

Spontaneous Perforation of the Extrahepatic Bile Ducts–Pathogenesis and Management: Case Report and Review of the Literature

Annals of Saudi Medicine ◽

10.5144/0256-4947.1992.496 ◽

1992 ◽

Vol 12 (5) ◽

pp. 496-498

Author(s):

Ahmed H. Al-Salem ◽

Ahmed Al-Faraj

Keyword(s):

Case Report ◽

Bile Ducts ◽

Spontaneous Perforation ◽

Review Of The Literature ◽

Extrahepatic Bile Ducts

Download Full-text

PEO 5009 Case report: Rabdomyosarcoma of the extrahepatic bile ducts

Ultrasound in Medicine & Biology ◽

10.1016/s0301-5629(97)80632-1 ◽

1997 ◽

Vol 23 ◽

pp. S87

Author(s):

Osvaldo Iban˜ez ◽

Azucena Urrutia ◽

Daniel Pollono ◽

Marcela Gatti ◽

Mario Zaritzky

Keyword(s):

Case Report ◽

Bile Ducts ◽

Extrahepatic Bile Ducts

Download Full-text

THE CHOICE OF PANCREATOJEJUNO-ANASTOMOS TECHNIQUE FOR PANCREATO-DUODENAL RESECTION

Kharkiv Surgical School ◽

10.37699/2308-7005.3.2020.02 ◽

2020 ◽

pp. 11-15

Author(s):

N. N. Veligotsky ◽

S. E. Arutyunov ◽

I. V. Teslenko ◽

A. S. Chebotarev

Keyword(s):

Risk Factors ◽

Pancreatic Fistula ◽

Low Risk ◽

Type B ◽

Pancreatic Parenchyma ◽

Optimal Technique ◽

Wirsung Duct ◽

Duodenal Resection

Summary. Objective. Development of an algorithm for choosing the method of pancreatojejunoanastomosis in pancreatoduodenal resection, taking into account the degree of change in the pancreatic parenchyma. Materials and methods. Pancreatoduodenal resection was performed on 291 patients with obstructive diseases of the pancreatoduodenal zone. Three options were used for pancreatojejunoanastomos: invagination ductopancreatojejunal — in 210 (72.4 %), invagination pancreatojejunal — in 68 (23.4 %), pancreatojejunal with bandage repair of the crescent ligament of the liver — in 13 (4.4 %) patients. Results. The pancreatic parenchyma was assessed by the following factors: puffiness, infiltration, obesity, degree of pancreatic parenchyma fibrosis, location and diameter of the Wirsung duct. High and low risk factors for the development of pancreatic fistula were identified. Diagnosis of pancreatic fistula was carried out according to the classification of ISGPF (2016). A differentiated approach was applied to the choice of pancreatojejunoanastomosis depending on the degree of changes in the pancreatic parenchyma, the diameter and location of the Wirsung duct. Conclusion. Evaluation of the degree of pancreatic parenchyma changes, the diameter and location of the Wirsung duct allows you to choose the optimal technique for pancreatojejunoanastomosis in pancreatoduodenal resection. The use of a differentiated approach to the choice of pancreatojejunoanastomosis technique for pancreatoduodenal resection, taking into account the degree of change in the pancreatic parenchyma, can reduce the incidence of PF (type B, C).

Download Full-text

Carcinoma of the Distal Extrahepatic Bile Ducts: Case Report

ANZ Journal of Surgery ◽

10.1111/j.1445-2197.1970.tb05380.x ◽

1970 ◽

Vol 39 (4) ◽

pp. 393-395 ◽

Cited By ~ 2

Author(s):

David Thomas

Keyword(s):

Case Report ◽

Bile Ducts ◽

Extrahepatic Bile Ducts

Download Full-text

The Use of the Gallbladder Wall for Reconstruction of the Extrahepatic Bile Ducts in a Case of Agenesis of the Common Bile Duct: A Case Report

Clinical Medical Reviews and Case Reports ◽

10.23937/2378-3656/1410106 ◽

2016 ◽

Vol 3 (5) ◽

Author(s):

Maher N Ghabriel

Keyword(s):

Case Report ◽

Bile Duct ◽

Common Bile Duct ◽

Bile Ducts ◽

Gallbladder Wall ◽

Extrahepatic Bile Ducts ◽

The Common

Download Full-text

An unusual presentation of epigastric pain due to thrombophlebitis of a recanalised umbilical vein – case report

Perspectives in Surgery ◽

10.33699/pis.2019.98.8.326-327 ◽

2019 ◽

Vol 98 (8) ◽

pp. 326-327 ◽

Cited By ~ 1

Keyword(s):

Liver Cirrhosis ◽

Abdominal Pain ◽

Case Report ◽

Portal Hypertension ◽

Liver Disease ◽

Epigastric Pain ◽

Umbilical Vein ◽

History Of ◽

Clinically Significant ◽

Inflammatory Changes

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.

Download Full-text