Bifid Pancreatic Tail: an Anatomical Case Series and their Classification

Anomalies and variants of development of the pancreas are relatively frequent. Bifid pancreatic tail is a rare anatomic variation with only a few cases reported in the literature. The present case series were encountered during dissection of 50 anatomical specimens of the pancreas, spleen, and duodenum. We observed four unusual cases (8%) of bifid pancreatic tail. One case was of a vertically oriented bifid pancreas tail (2%), in another case, the tails here horizontally oriented (2%) and in two cases the bifid tails were horizontally oriented but unequal (4%). The bifid tails had an arterial supply that penetrated the glands between the tails and two out of four were also supplied by the superior horizontal pancreatic artery of Popova. The ductal system usually bifurcated at the level of the tails, but a case of trifurcation was also encountered. The current cases should be taken into account in hepato-pancreato-biliary surgery to avoid misdiagnosis and to comprehensively assess the patient preoperatively.

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Anomalous arterial supply to the gallbladder from the superior mesenteric artery: angiography and computed tomography findings in two cases

Acta Radiologica ◽

10.1080/02841850802282829 ◽

2008 ◽

Vol 49 (9) ◽

pp. 987-990 ◽

Cited By ~ 1

Author(s):

Y. Katada ◽

M. Kishino ◽

K. Ishihara ◽

T. Takeguchi ◽

H. Shibuya

Keyword(s):

Computed Tomography ◽

Superior Mesenteric Artery ◽

Hepatic Artery ◽

Mesenteric Artery ◽

Cystic Artery ◽

Arterial Supply ◽

Hepatic Arteries ◽

Right Hepatic Artery ◽

Pancreatic Artery ◽

The Right

The arterial supply of the gallbladder usually arises from the right hepatic artery. Other origins include the left, proper, and common hepatic arteries. We report cases of the cystic artery arising from the superior mesenteric artery and arising from the dorsal pancreatic artery originating in turn from the superior mesenteric artery, as demonstrated by angiography and computed tomography.

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Ninety-Day and In-hospital Mortalities After Gastrointestinal and Hepatopancreatic Biliary Surgery—a Case Series Analysis

Indian Journal of Surgery ◽

10.1007/s12262-022-03286-7 ◽

2022 ◽

Author(s):

Bhavin Vasavada ◽

Hardik Patel

Keyword(s):

Case Series ◽

Biliary Surgery ◽

Series Analysis

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Indocyanine Green Fluorescence to Evaluate Nasoseptal Flap Viability in Endoscopic Endonasal Cranial Base Surgery

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0037-1602777 ◽

2017 ◽

Vol 78 (05) ◽

pp. 408-412 ◽

Cited By ~ 6

Author(s):

Edward Kerr ◽

Ali Jamshidi ◽

Ricardo Carrau ◽

Raewyn Campbell ◽

Leo Filho ◽

...

Keyword(s):

Indocyanine Green ◽

Early Recognition ◽

Medical Center ◽

Tertiary Care ◽

Case Series ◽

Arterial Supply ◽

Cerebrospinal Fluid Leakage ◽

Nasoseptal Flap ◽

Endoscopic Endonasal ◽

Flap Viability

Objectives The pedicled nasoseptal flap (NSF) has dramatically reduced postoperative cerebrospinal fluid leakage following endoscopic endonasal approach (EEA) surgery. Although rare, its arterial supply may be damaged during harvest or may be preoperatively damaged for numerous reasons. Early recognition permits harvesting a contralateral flap before sacrificing its pedicle as part of the surgical exposure or use of an alternative flap. Design Technical feasibility study and case series. Setting Tertiary care university-associated medical center. Participants Five patients requiring an EEA with NSF reconstruction. Main Outcome Measures During NSF harvest, intravenous indocyanine green (IVICG) was administered, and a customized endoscopic system was used to visualize the emerging fluorescence. At the end of each case, just before final positioning of the NSF, additional IVICG was administered, and the custom endoscope was again introduced to evaluate fluorescence. Results In four patients, the entire NSF fluoresced brightly with IVICG on initial harvest and before final positioning. One patient showed heterogeneous fluorescence of the pedicle and distal parts of the NSF at both stages. All NSFs healed well without complication. Conclusion IVICG facilitates real-time evaluation NSF's arterial supply. This may provide early recognition of arterial compromise, allowing the harvest of alternate flaps or modification of surgery.

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Life-threatening perianaesthetic complications in five cats undergoing biliary tract surgery: case series and literature review

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x16646152 ◽

2016 ◽

Vol 19 (6) ◽

pp. 717-722

Author(s):

Paolo Monticelli ◽

Thaleia Rengina Stathopoulou ◽

Karla Lee ◽

Chiara Adami

Keyword(s):

Biliary Tract ◽

Case Series ◽

Biliary Tree ◽

Common Finding ◽

Biliary Surgery ◽

Biliary Tract Surgery ◽

Alternative Treatment Option ◽

Life Threatening ◽

Surgical Manipulation ◽

Queen Mother

Case series summary The aim of this case series was to describe the intra- and early postanaesthetic complications occurring in five cats undergoing major surgeries involving the gallbladder and the biliary tree. The five cases of this series were admitted to the Queen Mother Hospital for Animals between June and December 2015, and were all overseen by the same senior anaesthesist. Pre-existing pancreatitis was a common finding. Observed life-threatening events were persistent, unresponsive hypotension in the absence of major blood loss, which occurred mainly during surgical manipulation of the biliary tract, and postoperative renal failure. Relevance and novel information Biliary surgery carries the potential for life-threatening complications in cats. The pathogenesis of such morbidities is likely to be multifactorial. The perianaesthetic use of haemoglobin-based oxygen-carrying solution may be considered as an alternative treatment option when hypotension is unresponsive to fluids and traditional positive inotropes and vasopressors.

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Right gastroepiploic artery arising from the dorsal pancreatic artery: a very rare anatomic variation underlying interesting embryologic implications

Surgical and Radiologic Anatomy ◽

10.1007/s00276-014-1273-y ◽

2014 ◽

Vol 37 (1) ◽

pp. 109-114 ◽

Cited By ~ 1

Author(s):

Flavio Di Gregorio ◽

Marì Regoli ◽

Giuseppe Botta ◽

Eugenio Bertelli

Keyword(s):

Anatomic Variation ◽

Gastroepiploic Artery ◽

Right Gastroepiploic Artery ◽

Dorsal Pancreatic Artery ◽

Pancreatic Artery

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The Use of the Dorsal Metacarpal Artery for Reconstruction of Distal Dorsal Finger Defects: An Anatomic Study and Clinical Experience

Archives of Hand and Microsurgery ◽

10.12790/ahm.21.0128 ◽

2021 ◽

Author(s):

Kanghee Lee ◽

Taehee Jo ◽

Woonhyeok Jeong ◽

Junhyung Kim ◽

Daegu Son ◽

...

Keyword(s):

Anatomic Variation ◽

Case Series ◽

Operation Time ◽

Anatomical Study ◽

Cadaver Study ◽

Anatomic Study ◽

Dorsal Metacarpal Artery ◽

The Mean ◽

Tissue Defects

Purpose: Dorsal metacarpal artery (DMA) flaps have been used successfully for distal dorsal finger defects. Some studies have reported inconsistent DMA anatomy, and there have been no studies on the anatomic variation of DMAs in Asian cadavers. Therefore, we evaluated the anatomy of DMA using Korean fresh cadavers and reported the clinical outcomes of the DMA flaps.Methods: In the cadaver study, four human forearms from adult fresh cadavers were dissected. The dorsal metacarpal arteries and their communicating branches were identified. From July 2016 to June 2019, five patients with dorsal finger defects underwent a first DMA (FDMA) flap or a reversed DMA (RDMA) flap.Results: In our cadaver study, the ulnar branch of the FDMA and the second and third DMAs were absent in two of four (50%) of the cadavers. In our case series, five flaps survived, and one had partial necrosis, which healed by the second intention. The mean operation time was approximately 100 minutes, and the mean outpatient follow-up period was 6 months.Conclusion: DMA flaps are a reliable flap for the reconstruction of relatively large soft tissue defects of the dorsal finger. However, in our anatomical study, inconsistency of the anatomy of DMAs was identified. Therefore, preoperative Doppler examination is required to evaluate the anatomy of the DMA before considering the use of DMA flaps.

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The operative management of gallstone ileus

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12664192076377 ◽

2010 ◽

Vol 92 (4) ◽

pp. 279-281 ◽

Cited By ~ 52

Author(s):

Reena Ravikumar ◽

J Graham Williams

Keyword(s):

Bowel Obstruction ◽

Gallstone Ileus ◽

Case Series ◽

Operative Management ◽

Biliary Surgery ◽

One Stage ◽

Ovid Medline ◽

Risk Patients ◽

Extent Of Surgery ◽

Medical Advances

INTRODUCTION Gallstone ileus is an uncommon entity, which accounts for 1–4% of all presentations to hospital with small bowel obstruction and for up to 25% of all cases in patients over 65 years of age. Despite medical advances over the last 350 years, gallstone ileus is still associated with high rates of morbidity and mortality. The management of gallstone ileus remains controversial. Whilst open surgery has been the mainstay of treatment, more recently other approaches have been employed, including laparoscopic surgery and lithotripsy. However, controversy persists primarily in relation to the extent of surgery performed. MATERIALS AND METHODS A literature review was performed in an attempt to discover the optimal surgical treatment of gallstone ileus, particularly the timing of biliary surgery. Published articles were identified from the medical literature by electronic searches of Pubmed and Ovid Medline databases, using the search terms ‘gallstone ileus’, ‘gallstone/intestinal obstruction’ and ‘gallstone/bowel obstruction’. The related articles function of the search engines was also used to maximise the number of articles identified. Relevant articles were retrieved and additional articles were identified from the references cited in these articles. RESULTS AND CONCLUSIONS The literature on gallstone ileus is composed entirely of retrospective analysis of small numbers of patients accumulated over many years. The question as to whether one stage or interval biliary surgery should be performed remains unanswered and it is unlikely that further case series will help decision making in the management of gallstone ileus. Whilst many authors conclude that enterolithotomy alone is the best option in most patients, a one-stage procedure should be considered for low-risk patients.

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Ninety Days and In-Hospital Mortality after Gastrointestinal and Hepatopancreatic Biliary Surgery- A Case Series Analysis.

10.21203/rs.3.rs-900976/v1 ◽

2021 ◽

Author(s):

bhavin bhuendra vasavada ◽

Hardik patel

Keyword(s):

Acute Kidney Injury ◽

Multivariate Analysis ◽

Hospital Mortality ◽

Emergency Surgery ◽

Open Surgery ◽

Case Series ◽

Kidney Injury ◽

Biliary Surgery ◽

Parametric Data ◽

Procedural Complications

Abstract Aim: The aim was to do a retrospective analysis and audit of our 90 days and in-hospital mortality after gastrointestinal and hepatopancreatic biliary surgery performed in our department and analyze factors predicting it.Patients and methods:All patients who underwent gastrointestinal and hepatopancreatic biliary surgery in our department in the last 3 years were evaluated for 90 days postoperative and in-hospital mortality and various factors affecting it. Categorical values were analyzed using the chi-square test or fisher's exact test wherever appropriate. Continuous variables were analyzed using the student t-test for parametric data and Mann Whitney U test for nonparametric data after skewness and kurtosis analysis. Multivariate analysis was done using logistic regression analysis. A p-value less than 0.05 was considered statistically significant. Statistical analysis was done using SPSS version 23(IBM).Results:412 patients underwent gastrointestinal and hepatobiliary surgery in the last 3 years at our institute. Ninety days all-cause mortality was 5.8%, all-cause in-hospital mortality was around 4.6%. 90 days mortality in elective and emergency surgeries were respectively 3.2% and 18%. In-hospital mortality in elective and emergency surgeries were respectively 2.35% and 15.2%. On multivariate analysis age, nontechnical complications, open surgery, and emergency surgery independently predicted 90 days mortality. On multivariate analysis age, acute kidney injury, non-procedural complications, and emergency surgeries independently predicted in-hospital mortalities.Conclusion:Age, non-technical complications, open surgery, and emergency surgeries are independently associated with 90 days mortality, and age, acute kidney injury, non-procedural complications, and emergency surgery independently predict in-hospital mortality.

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