Fistula
Pancreaticojejunostomy
Pancreaticoduodenectomy
Cutaneous Fistula
Arteriovenous Fistula
Intestinal Fistula
Biliary Fistula
Pancreatic Ducts
Bronchial Fistula
Vascular Fistula
Rectal Fistula
Urinary Fistula
Surgical Stapling
Esophageal Fistula
Pancreas
Gastrostomy
Postoperative Complications
Pancreatic Pseudocyst
Respiratory Tract Fistula
Vaginal Fistula
Suture Techniques
Tracheoesophageal Fistula
Jejunostomy
Pancreatic Neoplasms
Pancreatic Juice
Octreotide
Treatment Outcome
Urinary Bladder Fistula
Amylases
Arterio-Arterial Fistula
Anastomosis, Surgical
Endoscopy
Arteriovenous Shunt, Surgical
Anastomosis, Roux-en-Y
Carotid-Cavernous Sinus Fistula
Retrospective Studies
Gastrectomy
Pancreatitis, Chronic
Reoperation
Secretin
Surgical Procedures, Elective
Cholangiopancreatography, Endoscopic Retrograde
Digestive System Fistula
Central Nervous System Vascular Malformations
Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial. (1/165)
OBJECTIVE: To evaluate the endpoints of complications (specifically pancreatic fistula and total complications) and death in patients undergoing pancreaticoduodenectomy. SUMMARY BACKGROUND DATA: Four randomized, placebo-controlled, multicenter trials from Europe have evaluated prophylactic octreotide (the long-acting synthetic analog of native somatostatin) in patients undergoing pancreatic resection. Each trial reported significant decreases in overall complication rates, and two of the four reported significantly lowered rates of pancreatic fistula in patients receiving prophylactic octreotide. However, none of these four trials studied only pancreaticoduodenal resections, and all trials had high pancreatic fistula rates (>19%) in the placebo group. A fifth randomized trial from the United States evaluated the use of prophylactic octreotide in patients undergoing pancreaticoduodenectomy and found no benefit to the use of octreotide. Prophylactic use of octreotide adds more than $75 to the daily hospital charge in the United States. In calendar year 1996, 288 patients received octreotide on the surgical service at the authors' institution, for total billed charges of $74,652. METHODS: Between February 1998 and February 2000, 383 patients were recruited into this study on the basis of preoperative anticipation of pancreaticoduodenal resection. Patients who gave consent were randomized to saline control versus octreotide 250 microg subcutaneously every 8 hours for 7 days, to start 1 to 2 hours before surgery. The primary postoperative endpoints were pancreatic fistula, total complications, death, and length of hospital stay. RESULTS: Two hundred eleven patients underwent pancreaticoduodenectomy with pancreatic-enteric anastomosis, received appropriate saline/octreotide doses, and were available for endpoint analysis. The two groups were comparable with respect to demographics (54% male, median age 66 years), type of pancreaticoduodenal resection (60% pylorus-preserving), type of pancreatic-enteric anastomosis (87% end-to-side pancreaticojejunostomy), and pathologic diagnosis. The pancreatic fistula rates were 9% in the control group and 11% in the octreotide group. The overall complication rates were 34% in the control group and 40% in the octreotide group; the in-hospital death rates were 0% versus 1%, respectively. The median postoperative length of hospital stay was 9 days in both groups. CONCLUSIONS: These data demonstrate that the prophylactic use of perioperative octreotide does not reduce the incidence of pancreatic fistula or total complications after pancreaticoduodenectomy. Prophylactic octreotide use in this setting should be eliminated, at a considerable cost savings. (+info)Radical distal pancreatectomy with en bloc resection of the celiac artery, plexus, and ganglions for advanced cancer of the pancreatic body: a preliminary report on perfect pain relief. (2/165)
OBJECTIVE: The purpose of this study was to report the effect of radical distal pancreatectomy with en bloc resection of the celiac artery, plexus, and ganglions for locally advanced cancer of the pancreatic body on intractable abdominal and/or back pain and to explore the histopathologic mechanism of this pain. PATIENTS: Five patients with pancreatic body cancer involving the celiac and/or common hepatic artery underwent this radical surgery intended to cure the cancer. DESIGN: A retrospective analysis was performed. MAIN OUTCOME MEASURES: Surgical magnitude, postoperative pain control, postoperative outcome, and histopathologic findings were studied. RESULTS: Arterial reconstruction, gastrointestinal reconstruction, and blood transfusions were unnecessary. The organ deficit was limited to the distal pancreas, spleen and left adrenal gland. There was no postoperative mortality. Postoperative complications occurred in four patients, who were successfully managed with medical treatment. This led to prolonged hospital stays. The intractable preoperative abdominal and/or back pain was completely relieved immediately after surgery in all patients. Perfect pain control has been maintained from surgery to the last follow-up. Histopathologic examination of the surgical specimens revealed cancer invasion of the celiac plexus in all patients. CONCLUSIONS: This operation offers not only disease radicality but also perfect pain relief. The survival benefit has not yet been fully defined. (+info)Temporary fibrin glue occlusion of the main pancreatic duct in the prevention of intra-abdominal complications after pancreatic resection: prospective randomized trial. (3/165)
OBJECTIVE: To determine whether temporary occlusion of the main pancreatic duct with human fibrin glue decreases the incidence of intra-abdominal complications after pancreatoduodenectomy (PD) or distal pancreatectomy (DP). SUMMARY BACKGROUND DATA: To the authors' knowledge, there are no randomized studies comparing outcomes after pancreatic resection with or without main pancreatic duct occlusion by injection of fibrin glue. Of three nonrandomized studies, two reported no fistulas after intracanal injection and ductal occlusion with fibrin glue after PD with immediate pancreatodigestive anastomosis, while another study reported no protective effect of glue injection. METHODS: This prospective, randomized, single-blinded, multicenter study, conducted between January 1995 and January 1999, included 182 consecutive patients undergoing PD followed by immediate pancreatic anastomosis or DP, whether for benign or malignant tumor or for chronic pancreatitis. One hundred two underwent pancreatic resection followed by ductal occlusion with fibrin glue (made slowly resorbable by the addition of aprotinin); 80 underwent resection without ductal occlusion. The main end point was the number of patients with one or more of the following intra-abdominal complications: pancreatic or other digestive tract fistula, intra-abdominal collections (infected or not), acute pancreatitis, or intra-abdominal or digestive tract hemorrhage. Severity factors included postoperative mortality, repeat operations, and length of hospital stay. RESULTS: The two groups were similar in pre- and intraoperative characteristics except that there were significantly more patients in the ductal occlusion group who were receiving octreotide, who had reinforcement of their anastomosis by fibrin glue, and who had fibrotic pancreatic stumps. However, the rate of patients with one or more intra-abdominal complications, and notably with pancreatic fistula, did not differ significantly between the two groups. There was still no significant difference found after statistical adjustment for these patient characteristic discrepancies, confirming the inefficacy of fibrin glue. The rate of intra-abdominal complications was significantly higher in the presence of a normal, nonfibrotic pancreatic stump and main pancreatic duct diameter less than 3 mm, whereas reinforcement of the anastomosis with fibrin glue or use of octreotide did not influence outcome. In multivariate analysis, however, normal pancreatic parenchyma was the only independent risk factor for intra-abdominal complications. No significant differences were found in the severity of complications between the two groups. CONCLUSIONS: Ductal occlusion by intracanal injection of fibrin glue decreases neither the rate nor the severity of intra-abdominal complications after pancreatic resection. (+info)Comparison of vasoactive intestinal peptide and secretin in stimulation of pancreatic secretion. (4/165)
Pancreatic volume flow as well as bicarbonate and protein secretion have been measured in chronic pancreatic fistula cats and dogs in response to I.V. infusion of VIP and secretin or duodenal perfusion of sodium oleate and HCl solution. 2. VIP and secretin infused I.V. in cats produced superimposable pancreatic dose-response curves for volume flow and bicarbonate secretion, reaching almost identical observed and maximal calculated outputs with both peptides. In dogs, VIP was shown previously to be a much less effective stimulant of pancreatic secretion than secretin and the maximal observed bicarbonate output in response to VIP was only about 17% of that to secretin (Konturek, Thor, Dembinski & Krol, 1975). It is condluded that VIP in cats is a secretin-like full agonist, whereas in dogs it is a partial agonist of pancreatic bicarbonate secretion. 3. In cats, secretin and VIP showed equal efficacy and their combination exhibited an augmentatory action on pancreatic bicarbonate secretion with additive kinetics, whereas in dogs, VIP was found to have a lower efficacy than secretin and to inhibit competitively secretin-induced pancreatic secretion. These results might be explained by the interaction of VIP and secretin, two chemically related peptides, on a common receptor site of the exocrine pancreas. 4. Caerulein, an analogue of CCK-PZ, infused I.V. in cats and dogs caused a negligible pancreatic bicarbonate secretion and a potent dose-dependent protein secretion. The combination of graded doses of VIP or secretin with a background dose of caerulein resulted in significantly higher bicarbonate and protein outputs than those induced by VIP or secretin alone. 5. Duodenal perfusion of sodium oleate soap in cats and dogs produced pancreatic dose-response curves for volume flow and bicarbonate output similar to those evoked by VIP in these species. Pancreatic protein secretion in response to luminal oleate was slightly higher than could be accounted for by the action of VIP alone. This might be attributed to the release by oleate not only of endogenous VIP but also CCK-PZ or to the vago-vagal reflexes from gut to pancreas. The results of our combined study on cats and dogs suggest the possibility that oleate releases VIP from the gut and that this peptide may play a physiological role in the stimulation of pancreatic secretion. (+info)Pancreaticogastrostomy after pancreatoduodenectomy. (5/165)
The aim of this study was to evaluate the place of pancreaticogastrostomy (PG) in reducing pancreatic fistula after pancreatoduodenectomy. From January 1988 to June 1991, 32 consecutive patients (mean age, 57 years) were operated on, 25 for malignant disease (78%). The pancreatic remnant was normal in 17 patients (53%) and sclerotic in the others. There was one operative death (3.1%) unrelated to PG. Post-operative complications occurred in five patients (16%). Only two complications were related to PG: 1 patient had anastomotic intra-gastric bleeding and was reoperated on, 1 patient with a normal pancreatic remnant developed a pancreatic fistula (3.1%) treated conservatively. Reported series of PG, as well as our results, demonstrates that PG is associated with a dramatic decrease of both pancreatic fistula and mortality rates. The risk of anastomotic haemorrhage can be reduced by preventative ligation of submucosal gastric vessels. In conclusion, PG appears as a simple and reliable method of management of the pancreatic remnant after pancreatoduodenectomy. (+info)Surgical treatment of pancreatic carcinoma. (6/165)
OBJECTIVE: To evaluate the surgical treatment of pancreatic carcinoma. METHODS: 101 patients with pancreatic carcinoma admitted from 1995 to 2002 were studied retrospectively. Of 83 patients undergoing surgery, 56 (64.5%) were subjected to tumor resection. Whipple's procedure was performed in 48 patients, extended regional pancreatectomy and autograft intestinal transplantation in 2, combined resection of pancreatic body or tail carcinoma in 6, and 27 patients with unresectable pancreatic carcinoma were given inner drainage. RESULTS: Wound dehiscence and digestive bleeding were found in one patient respectively. Pancreatic fistula was found in one patient undergoing extended regional pancreatectomy and autograft intestinal transplantation. Other patients recovered uneventfully. CONCLUSIONS: Most patients with pancreatic carcinoma could undergo tumor resection. Blood vessel repair or transplantation can be used if the tumor adherent to the superior mesenteric-portal vein. Extended regional pancreatectomy and autograft intestinal transplantation are feasible. Simple inner drainage should be used in the patient whose neoplasm is unresectable. (+info)Surgical treatment of chronic pancreatitis. (7/165)
OBJECTIVE: To summarize the experience in the surgical treatment of chronic pancreatitis. METHODS: 189 patients with pancreatitis admitted from May 1983 to August 1999 to our hospital were reviewed. RESULTS: 136 (72%) patients received surgical treatment including pancreatoduodenectomy (15 patients), distal pancreatectomy (12), internal drainage of pancreatic pseudocyst (28), side-to-side pancreaticojejunostomy (16), relief of biliary stenosis (58), and pancreatic biopsy (7). Pain was relieved in 97.8% of the patients, and the complication rate was 1.5%. CONCLUSIONS: It is crucial to select various surgical strategies at a proper time for chronic pancreatitis patients. Patients with chronic pancreatitis complicated by dilation or obstruction of the pancreatic duct or with biliary pancreatitis should be operated on in early stages, whereas those with other types of chronic pancreatitis should receive the therapy focusing on the alleviation of their symptoms, not on early surgical intervention. The timing and modality of surgery are important in improving the life quality of the patients and changing their natural history of the disease. (+info)Role of leptin in the control of postprandial pancreatic enzyme secretion. (8/165)
Leptin released by adipocytes has been implicated in the control of food intake but recent detection of specific leptin receptors in the pancreas suggests that this peptide may also play some role in the modulation of pancreatic function. This study was undertaken to examine the effect of exogenous leptin on pancreatic enzyme secretion in vitro using isolated pancreatic acini, or in vivo in conscious rats with chronic pancreatic fistulae. Leptin plasma level was measured by radioimmunoassay following leptin administration to the animals. Intraperitoneal (i.p.) administration of leptin (0.1, 1, 5, 10, 20 or 50 microg/kg), failed to affect significantly basal secretion of pancreatic protein, but markedly reduced that stimulated by feeding. The strongest inhibition has been observed at dose of 10 microg/kg of leptin. Under basal conditions plasma leptin level averaged about 0.15 +/- 0.04 ng/ml and was increased by feeding up to 1.8 +/- 0.4 ng/ml. Administration of leptin dose-dependently augmented this plasma leptin level, reaching about 0.65 +/- 0.04 ng/ml at dose of 10 microg/kg of leptin. This dose of leptin completely abolished increase of pancreatic protein output produced by ordinary feeding, sham feeding or by diversion of pancreatic juice to the exterior. Leptin (10(-10)-10(-7) M) also dose-dependently attenuated caerulein-induced amylase release from isolated pancreatic acini, whereas basal enzyme secretion was unaffected. We conclude that leptin could take a part in the inhibition of postprandial pancreatic secretion and this effect could be related, at least in part, to the direct action of this peptide on pancreatic acini. (+info)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.
A fistula is an abnormal connection or passage between two organs, vessels, or body parts that usually do not connect. It can form as a result of injury, infection, surgery, or disease. A fistula can occur anywhere in the body but commonly forms in the digestive system, genital area, or urinary system. The symptoms and treatment options for a fistula depend on its location and underlying cause.
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.
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 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.
A cutaneous fistula is a type of fistula that occurs when a tract or tunnel forms between the skin (cutaneous) and another organ or structure, such as the gastrointestinal tract, vagina, or urinary system. Cutaneous fistulas can result from various medical conditions, including infections, inflammatory diseases, surgical complications, trauma, or malignancies.
Cutaneous fistulas may present with symptoms such as drainage of fluid or pus from the skin, pain, redness, swelling, or irritation around the affected area. The treatment for cutaneous fistulas depends on their underlying cause and can range from conservative management with antibiotics and wound care to surgical intervention.
It is essential to seek medical attention if you suspect a cutaneous fistula, as untreated fistulas can lead to complications such as infection, sepsis, or tissue damage. A healthcare professional can provide an accurate diagnosis and develop an appropriate treatment plan based on the individual's needs.
An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. This connection causes blood to flow directly from the artery into the vein, bypassing the capillary network that would normally distribute the oxygen-rich blood to the surrounding tissues.
Arteriovenous fistulas can occur as a result of trauma, disease, or as a planned surgical procedure for patients who require hemodialysis, a treatment for advanced kidney failure. In hemodialysis, the arteriovenous fistula serves as a site for repeated access to the bloodstream, allowing for efficient removal of waste products and excess fluids.
The medical definition of an arteriovenous fistula is:
"An abnormal communication between an artery and a vein, usually created by surgical means for hemodialysis access or occurring as a result of trauma, congenital defects, or disease processes such as vasculitis or neoplasm."
A gastric fistula is an abnormal connection or passage between the stomach and another organ or the skin surface. This condition can occur as a result of complications from surgery, injury, infection, or certain diseases such as cancer. Symptoms may include persistent drainage from the site of the fistula, pain, malnutrition, and infection. Treatment typically involves surgical repair of the fistula and management of any underlying conditions.
An intestinal fistula is an abnormal communication or connection between the intestines (or a portion of the intestine) and another organ or the skin surface. This connection forms a tract or passage, allowing the contents of the intestines, such as digestive enzymes, bacteria, and waste materials, to leak into other body areas or outside the body. Intestinal fistulas can develop due to various reasons, including inflammatory bowel diseases (like Crohn's disease), infections, complications from surgery, radiation therapy, or trauma. They can cause symptoms such as abdominal pain, diarrhea, skin irritation, and infection. Treatment of intestinal fistulas often involves a combination of medical management, nutritional support, and surgical intervention.
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 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.
A bronchial fistula is an abnormal connection or passage between the bronchial tree (the airways in the lungs) and the surrounding tissues, such as the pleural space (the space between the lungs and the chest wall), blood vessels, or other organs. This condition can result from various causes, including lung injury, infection, surgery, or certain diseases such as cancer or tuberculosis.
Bronchial fistulas can lead to symptoms like coughing, wheezing, shortness of breath, and chest pain. They may also cause air leaks, pneumothorax (collapsed lung), or chronic infections. Treatment for bronchial fistulas depends on the underlying cause and severity of the condition but often involves surgical repair or closure of the abnormal connection.
A vascular fistula is an abnormal connection or passage between the artery and vein, which usually results from a surgical procedure to create access for hemodialysis in patients with chronic kidney disease. This communication allows blood to flow directly from the artery into the vein, bypassing the capillary network and causing high-flow conditions in the affected area. Over time, the increased pressure and flow can lead to various complications such as venous hypertension, stenosis, aneurysm formation, or even heart failure if left untreated. Vascular fistulas may also occur spontaneously due to certain medical conditions like vasculitis, trauma, or infection, although this is less common.
A rectal fistula is an abnormal connection or tunnel that develops between the rectum, which is the lower end of the colon, and another organ or the skin surface surrounding the anus. This condition often results from inflammation, infection, trauma, or surgery in the anal area. The fistula can cause symptoms such as pain, discharge, irritation, and swelling around the anus. In some cases, it may also lead to complications like abscesses or recurrent infections if not treated promptly and effectively. Treatment options typically include surgical intervention to close the fistula and promote healing of the affected tissues.
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.
A urinary fistula is an abnormal connection or passage between the urinary tract and another organ or tissue, such as the bladder, ureter, or kidney, and the skin, vagina, or intestine. This condition can lead to urine leakage through the abnormal opening, causing discomfort, infection, and other complications if not treated promptly and effectively. Urinary fistulas can be caused by various factors, including surgery, injury, radiation therapy, inflammation, or cancer. The type and location of the fistula will determine the specific symptoms and treatment options.
Surgical stapling is a medical technique that uses specialized staplers to place linear staple lines to close surgical incisions, connect or remove organs and tissues during surgical procedures. Surgical staples are made of titanium or stainless steel and can be absorbable or non-absorbable. They provide secure, fast, and accurate wound closure, reducing the risk of infection and promoting faster healing compared to traditional suturing methods.
The surgical stapler consists of a handle, an anvil, and a cartridge containing multiple staples. The device is loaded with staple cartridges and used to approximate tissue edges before deploying the staples. Once the staples are placed, the stapler is removed, leaving the staple line in place.
Surgical stapling has various applications, including gastrointestinal anastomosis, lung resection, vascular anastomosis, and skin closure. It is widely used in different types of surgeries, such as open, laparoscopic, and robotic-assisted procedures. The use of surgical stapling requires proper training and expertise to ensure optimal patient outcomes.
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.
An esophageal fistula is an abnormal connection or passage between the esophagus (the tube that carries food and liquids from the throat to the stomach) and another organ, such as the trachea (windpipe) or the skin. This condition can result from complications of certain medical conditions, including cancer, prolonged infection, or injury to the esophagus.
Esophageal fistulas can cause a variety of symptoms, including difficulty swallowing, coughing, chest pain, and fever. They can also lead to serious complications, such as pneumonia or sepsis, if left untreated. Treatment for an esophageal fistula typically involves surgical repair of the abnormal connection, along with management of any underlying conditions that may have contributed to its development.
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.
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.
A rectovaginal fistula is an abnormal connection or passage between the rectum (the lower end of the colon, leading to the anus) and the vagina. This type of fistula can result from various causes, such as childbirth injuries, surgery complications, Crohn's disease, radiation therapy, or infections. The condition may lead to symptoms like fecal matter passing through the vagina, recurrent vaginal infections, discomfort during sexual intercourse, and skin irritation around the vaginal area. Treatment options typically involve surgical repair of the fistula, depending on its size, location, and underlying cause.
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.
A pancreatic pseudocyst is a fluid-filled sac that forms in the abdomen, usually as a result of pancreatitis or trauma to the pancreas. It is composed of cells and tissues from the pancreas, along with enzymes, debris, and fluids. Unlike true cysts, pseudocysts do not have an epithelial lining. They can vary in size and may cause symptoms such as abdominal pain, nausea, vomiting, or fever. In some cases, they may resolve on their own, but larger or symptomatic pseudocysts may require medical intervention, such as drainage or surgery.
A vesicovaginal fistula is an abnormal opening or connection between the bladder and the vagina, resulting in the continuous involuntary discharge of urine into the vaginal vault. This condition most commonly occurs as a result of complications during childbirth, particularly in developing countries with limited access to medical care. It can also be caused by surgery, radiation therapy, infection, or injury.
The symptoms of vesicovaginal fistula include constant urinary leakage from the vagina, frequent urinary tract infections, and a foul odor. The condition can lead to social isolation, depression, and other psychological issues due to its impact on a woman's quality of life. Treatment typically involves surgical repair of the fistula, which can be complex and may require specialized medical care.
A respiratory tract fistula is an abnormal connection or passage between the respiratory tract (which includes the nose, throat, windpipe, and lungs) and another organ or structure, such as the skin, digestive tract, or blood vessels. This condition can lead to complications such as air leakage, infection, and difficulty breathing. The causes of respiratory tract fistulas vary and can include trauma, surgery, infection, or cancer. Treatment depends on the location and severity of the fistula and may involve surgical repair, antibiotics, or other therapies.
A vaginal fistula is an abnormal opening or connection between the vagina and another organ, such as the bladder (resulting in a vesicovaginal fistula), the rectum (resulting in a rectovaginal fistula), or the colon (resulting in a colovaginal fistula). This condition can lead to various complications, including chronic urinary or fecal incontinence, infection, and difficulty with sexual intercourse.
Vaginal fistulas are often caused by obstetric trauma, such as prolonged labor, or may be the result of surgery, radiation therapy, injury, or infection. Symptoms can vary depending on the size and location of the fistula but typically include abnormal discharge, pain, and foul-smelling odor. Treatment usually involves surgical repair of the fistula, although smaller fistulas may sometimes heal on their own with proper care and management.
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.
A tracheoesophageal fistula (TEF) is an abnormal connection between the trachea (windpipe) and the esophagus (tube that carries food from the mouth to the stomach). This congenital anomaly is usually present at birth and can vary in size and location. It can cause complications such as respiratory distress, feeding difficulties, and recurrent lung infections. TEF is often treated surgically to separate the trachea and esophagus and restore their normal functions.
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.
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.
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.
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.
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.
A urinary bladder fistula is an abnormal connection or passage between the urinary bladder and another organ or structure, such as the skin, intestine, or vagina. This condition can result from various factors, including surgery, injury, infection, inflammation, radiation therapy, or malignancy.
Bladder fistulas may lead to symptoms like continuous leakage of urine through the skin, frequent urinary tract infections, and fecal matter in the urine (when the fistula involves the intestine). The diagnosis typically involves imaging tests, such as a CT scan or cystogram, while treatment often requires surgical repair of the fistula.
Amylases are enzymes that break down complex carbohydrates, such as starch and glycogen, into simpler sugars like maltose, glucose, and maltotriose. There are several types of amylases found in various organisms, including humans.
In humans, amylases are produced by the pancreas and salivary glands. Pancreatic amylase is released into the small intestine where it helps to digest dietary carbohydrates. Salivary amylase, also known as alpha-amylase, is secreted into the mouth and begins breaking down starches in food during chewing.
Deficiency or absence of amylases can lead to difficulties in digesting carbohydrates and may cause symptoms such as bloating, diarrhea, and abdominal pain. Elevated levels of amylase in the blood may indicate conditions such as pancreatitis, pancreatic cancer, or other disorders affecting the pancreas.
Cyst fluid refers to the fluid accumulated within a cyst, which is a closed sac-like or capsular structure, typically filled with liquid or semi-solid material. Cysts can develop in various parts of the body for different reasons, and the composition of cyst fluid may vary depending on the type of cyst and its location.
In some cases, cyst fluid might contain proteins, sugars, hormones, or even cells from the surrounding tissue. Infected cysts may have pus-like fluid, while cancerous or precancerous cysts might contain abnormal cells or tumor markers. The analysis of cyst fluid can help medical professionals diagnose and manage various medical conditions, including infections, inflammatory diseases, genetic disorders, and cancers.
It is important to note that the term 'cyst fluid' generally refers to the liquid content within a cyst, but the specific composition and appearance of this fluid may vary significantly depending on the underlying cause and type of cyst.
An arterio-arterial fistula is an abnormal connection or passage between two arteries. Arteries are blood vessels that carry oxygen-rich blood from the heart to the rest of the body. Under normal circumstances, arteries do not directly communicate with each other; instead, they supply blood to capillaries, which then deliver the blood to veins.
An arterio-arterial fistula can result from various causes, including congenital defects, trauma, or as a complication of medical procedures such as arterial catheterization or surgical interventions. The presence of an arterio-arterial fistula may lead to several hemodynamic consequences, depending on the size, location, and chronicity of the communication. These can include altered blood flow patterns, increased pressure in the affected arteries, and potential cardiac complications due to volume overload.
Symptoms of an arterio-arterial fistula may vary widely, from being asymptomatic to experiencing palpitations, shortness of breath, fatigue, or even congestive heart failure in severe cases. The diagnosis typically involves imaging studies such as ultrasound, CT angiography, or MRI angiography to visualize the abnormal communication and assess its hemodynamic impact. Treatment options may include observation, endovascular interventions, or surgical repair, depending on the individual case.
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.
Endoscopy is a medical procedure that involves the use of an endoscope, which is a flexible tube with a light and camera at the end, to examine the interior of a body cavity or organ. The endoscope is inserted through a natural opening in the body, such as the mouth or anus, or through a small incision. The images captured by the camera are transmitted to a monitor, allowing the physician to visualize the internal structures and detect any abnormalities, such as inflammation, ulcers, or tumors. Endoscopy can also be used for diagnostic purposes, such as taking tissue samples for biopsy, or for therapeutic purposes, such as removing polyps or performing minimally invasive surgeries.
An arteriovenous shunt is a surgically created connection between an artery and a vein. This procedure is typically performed to reroute blood flow or to provide vascular access for various medical treatments. In a surgical setting, the creation of an arteriovenous shunt involves connecting an artery directly to a vein, bypassing the capillary network in between.
There are different types of arteriovenous shunts used for specific medical purposes:
1. Arteriovenous Fistula (AVF): This is a surgical connection created between an artery and a vein, usually in the arm or leg. The procedure involves dissecting both the artery and vein, then suturing them directly together. Over time, the increased blood flow to the vein causes it to dilate and thicken, making it suitable for repeated needle punctures during hemodialysis treatments for patients with kidney failure.
2. Arteriovenous Graft (AVG): An arteriovenous graft is a synthetic tube used to connect an artery and a vein when a direct AVF cannot be created due to insufficient vessel size or poor quality. The graft can be made of various materials, such as polytetrafluoroethylene (PTFE) or Dacron. Grafts are more prone to infection and clotting compared to native AVFs but remain an essential option for patients requiring hemodialysis access.
3. Central Venous Catheter (CVC): A central venous catheter is a flexible tube inserted into a large vein, often in the neck or groin, and advanced towards the heart. CVCs can be used as temporary arteriovenous shunts for patients who require immediate hemodialysis access but do not have time to wait for an AVF or AVG to mature. However, they are associated with higher risks of infection and thrombosis compared to native AVFs and AVGs.
In summary, a surgical arteriovenous shunt is a connection between an artery and a vein established through a medical procedure. The primary purpose of these shunts is to provide vascular access for hemodialysis in patients with end-stage renal disease or to serve as temporary access when native AVFs or AVGs are not feasible.
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.
A Carotid-Cavernous Sinus Fistula (CCSF) is an abnormal connection between the carotid artery and the cavernous sinus, a venous structure in the skull. This connection can be either direct or indirect. Direct CCSFs are caused by trauma or rupture of an aneurysm, while indirect CCSFs are usually spontaneous and associated with conditions such as hypertension, atherosclerosis, or connective tissue disorders.
Symptoms of a CCSF may include headache, eye redness, protrusion of the eyeball, double vision, hearing disturbances, and pulsatile tinnitus (a rhythmic sound in the ear). The severity of symptoms can vary depending on the size of the fistula and the pressure within the cavernous sinus.
Treatment options for CCSF include endovascular repair with stenting or coiling, surgical closure, or observation, depending on the type and size of the fistula and the presence of symptoms.
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.
A splenectomy is a surgical procedure in which the spleen is removed from the body. The spleen is an organ located in the upper left quadrant of the abdomen, near the stomach and behind the ribs. It plays several important roles in the body, including fighting certain types of infections, removing old or damaged red blood cells from the circulation, and storing platelets and white blood cells.
There are several reasons why a splenectomy may be necessary, including:
* Trauma to the spleen that cannot be repaired
* Certain types of cancer, such as Hodgkin's lymphoma or non-Hodgkin's lymphoma
* Sickle cell disease, which can cause the spleen to enlarge and become damaged
* A ruptured spleen, which can be life-threatening if not treated promptly
* Certain blood disorders, such as idiopathic thrombocytopenic purpura (ITP) or hemolytic anemia
A splenectomy is typically performed under general anesthesia and may be done using open surgery or laparoscopically. After the spleen is removed, the incision(s) are closed with sutures or staples. Recovery time varies depending on the individual and the type of surgery performed, but most people are able to return to their normal activities within a few weeks.
It's important to note that following a splenectomy, individuals may be at increased risk for certain types of infections, so it's recommended that they receive vaccinations to help protect against these infections. They should also seek medical attention promptly if they develop fever, chills, or other signs of infection.
A Gastrectomy is a surgical procedure involving the removal of all or part of the stomach. This procedure can be total (complete resection of the stomach), partial (removal of a portion of the stomach), or sleeve (removal of a portion of the stomach to create a narrow sleeve-shaped pouch).
Gastrectomies are typically performed to treat conditions such as gastric cancer, benign tumors, severe peptic ulcers, and in some cases, for weight loss in individuals with morbid obesity. The type of gastrectomy performed depends on the patient's medical condition and the extent of the disease.
Following a gastrectomy, patients may require adjustments to their diet and lifestyle, as well as potential supplementation of vitamins and minerals that would normally be absorbed in the stomach. In some cases, further reconstructive surgery might be necessary to reestablish gastrointestinal continuity.
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.
"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.
A reoperation is a surgical procedure that is performed again on a patient who has already undergone a previous operation for the same or related condition. Reoperations may be required due to various reasons, such as inadequate initial treatment, disease recurrence, infection, or complications from the first surgery. The nature and complexity of a reoperation can vary widely depending on the specific circumstances, but it often carries higher risks and potential complications compared to the original operation.
Secretin is a hormone that is produced and released by the S cells in the duodenum, which is the first part of the small intestine. It is released in response to the presence of acidic chyme (partially digested food) entering the duodenum from the stomach. Secretin stimulates the pancreas to produce bicarbonate-rich alkaline secretions, which help neutralize the acidity of the chyme and create an optimal environment for enzymatic digestion in the small intestine.
Additionally, secretin also promotes the production of watery fluids from the liver, which aids in the digestion process. Overall, secretin plays a crucial role in maintaining the pH balance and facilitating proper nutrient absorption in the gastrointestinal tract.
Elective surgical procedures are operations that are scheduled in advance because they do not involve a medical emergency. These surgeries are chosen or "elective" based on the patient's and doctor's decision to improve the patient's quality of life or to treat a non-life-threatening condition. Examples include but are not limited to:
1. Aesthetic or cosmetic surgery such as breast augmentation, rhinoplasty, etc.
2. Orthopedic surgeries like knee or hip replacements
3. Cataract surgery
4. Some types of cancer surgeries where the tumor is not spreading or causing severe symptoms
5. Gastric bypass for weight loss
It's important to note that while these procedures are planned, they still require thorough preoperative evaluation and preparation, and carry risks and benefits that need to be carefully considered by both the patient and the healthcare provider.
Endoscopic retrograde cholangiopancreatography (ERCP) is a medical procedure that combines upper gastrointestinal (GI) endoscopy and fluoroscopy to diagnose and treat certain problems of the bile ducts and pancreas.
During ERCP, a flexible endoscope (a long, thin, lighted tube with a camera on the end) is passed through the patient's mouth and throat, then through the stomach and into the first part of the small intestine (duodenum). A narrow plastic tube (catheter) is then inserted through the endoscope and into the bile ducts and/or pancreatic duct. Contrast dye is injected through the catheter, and X-rays are taken to visualize the ducts.
ERCP can be used to diagnose a variety of conditions affecting the bile ducts and pancreas, including gallstones, tumors, strictures (narrowing of the ducts), and chronic pancreatitis. It can also be used to treat certain conditions, such as removing gallstones from the bile duct or placing stents to keep the ducts open in cases of stricture.
ERCP is an invasive procedure that carries a risk of complications, including pancreatitis, infection, bleeding, and perforation (a tear in the lining of the GI tract). It should only be performed by experienced medical professionals in a hospital setting.
A digestive system fistula is an abnormal connection or passageway that forms between the organs of the gastrointestinal tract, such as the stomach, small intestine, colon, or rectum, and another organ, tissue, or the skin. Fistulas can develop as a result of injury, surgery, infection, inflammation, or cancer.
In the digestive system, fistulas can cause symptoms such as abdominal pain, diarrhea, fever, nausea, vomiting, and malnutrition. The severity of these symptoms depends on the location and size of the fistula, as well as the underlying cause. Treatment for a digestive system fistula may involve antibiotics to treat infection, nutritional support, and surgical repair of the fistula.
Central nervous system (CNS) vascular malformations are abnormal tangles or masses of blood vessels in the brain or spinal cord. These malformations can be congenital (present at birth) or acquired (develop later in life). They can vary in size, location, and symptoms, which may include headaches, seizures, weakness, numbness, difficulty speaking or understanding speech, and vision problems.
There are several types of CNS vascular malformations, including:
1. Arteriovenous malformations (AVMs): These are tangles of arteries and veins with a direct connection between them, bypassing the capillary network. AVMs can cause bleeding in the brain or spinal cord, leading to stroke or neurological deficits.
2. Cavernous malformations: These are clusters of dilated, thin-walled blood vessels that form a sac-like structure. They can rupture and bleed, causing symptoms such as seizures, headaches, or neurological deficits.
3. Developmental venous anomalies (DVAs): These are benign vascular malformations characterized by an abnormal pattern of veins that drain blood from the brain. DVAs are usually asymptomatic but can be associated with other vascular malformations.
4. Capillary telangiectasias: These are small clusters of dilated capillaries in the brain or spinal cord. They are usually asymptomatic and found incidentally during imaging studies.
5. Moyamoya disease: This is a rare, progressive cerebrovascular disorder characterized by the narrowing or blockage of the internal carotid arteries and their branches. This can lead to decreased blood flow to the brain, causing symptoms such as headaches, seizures, and strokes.
The diagnosis of CNS vascular malformations typically involves imaging studies such as MRI or CT scans, and sometimes angiography. Treatment options may include observation, medication, surgery, or endovascular procedures, depending on the type, location, and severity of the malformation.
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.
Pancreatic fistula
Pancreaticoduodenectomy
Pancreatic injury
Derek Denton
Hypokalemia
Magnetic resonance elastography
Hyperchloremic acidosis
Robot-assisted surgery
Pancreatic abscess
Fistula
Wittmann Patch
Self-expandable metallic stent
Gastrointestinal disease
Interventional oncology
List of ICD-9 codes 520-579: diseases of the digestive system
Carl Gussenbauer
List of MeSH codes (C23)
Blind loop syndrome
List of dog diseases
Fabian Udekwu
Chronic pancreatitis
Gallbladder disease
Upper gastrointestinal bleeding
Foregut
Computed tomography enterography
List of MeSH codes (C06)
Deaths in March 2020
List of skin conditions
Meckel's diverticulum
Endoscopic retrograde cholangiopancreatography
Pancreatic fistula - Wikipedia
An easy-to-use score to predict clinically relevant postoperative pancreatic fistula after distal pancreatectomy - Minerva...
Intra-operative amylase in peri-pancreatic fluid independently predicts for pancreatic fistula post pancreaticoduodectomy
Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy | Cochrane Abstracts
"National Pancreatic Fistula Rates After Minimally Invasive Pancreatico" by Horacio Asbun
Postoperative white blood cell counts change after pancreatoduodenectomy: Early sign for pancreatic fistula
Pediatric Metabolic Acidosis: Background, Pathophysiology, Etiology
Insulinoma and Excess Insulin: Symptoms, Causes, Diagnosis, Treatment
Impact of endoscopic ultrasound-guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery. |...
Pancreatic Fistula after Pancreatectomy: Definitions, Risk Factors, Preventive Measures, and Management-Review, International...
Meta-analysis of pancreaticogastrostomy versus pancreaticojejunostomy on occurrences of postoperative pancreatic fistula after...
Splenic Abscess Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy
Incidence, predictors and clinical outcome of pancreatic fistula in patients receiving splenectomy for advanced or recurrent...
Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy?...
Morphological Features of Pancreatic Stump, Other than Wirsung Diameter and Pancreatic Texture, Influence Pancreatic Fistula...
Upper abdominal body shape is the risk factor for postoperative pancreatic fistula after splenectomy for advanced gastric...
The value and prognostic significance of neutrophil / lymphocyte ratio in predicting pancreatic fistula in patients undergoing...
Biomedical Science & Research Journals | Cost-Benefit Analysis: Hemopatch® Vs Standard of Care in The Incidence of...
Thieme E-Journals - The Surgery Journal / Full Text
Sandostatin, Sandostatin LAR (octreotide) dosing, indications, interactions, adverse effects, and more
Roux-En-Y Laparoscopic Pancreaticojejunostomy for Chronic Pancreatitis - SAGES Abstract Archives
Recent advances in artificial intelligence for pancreatic ductal adenocarcinoma
Hao Weng's Research on X-linked zinc finger protein | CureHunter
PancreatoduodenectomÃa por neoplasia biliopancreática, experiencia inicial, técnica y resultados en un Hospital de Alta...
dr. J. (Jeroen) Hagendoorn - UMC Utrecht
World Exocrine Pancreatic Insufficiency Market - Opportunities and Forecasts, 2017 - 2023
World Journal of Gastrointestinal Surgery - Baishideng Publishing Group
Ulrich Wellner - Google Scholar
Pylorus-Preserving Pancreaticoduodenectomy (PPPD): Background, Indications, Contraindications
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Pancreaticoduodenectomy23
- The measurement of WBC counts after pancreaticoduodenectomy can play a clinically important role in the early detection of pancreatic fistula development even from postoperative one day. (kjco.org)
- Despite significant improvements in the safety and efficacy of pancreatic surgery, pancreaticoenteric anastomosis continues to be the "Achilles heel" of pancreaticoduodenectomy, due to its association with a measurable risk of leakage or failure of healing, leading to pancreatic fistula. (sagepub.com)
- 1. Introduction Pancreaticoduodenectomy (PD) is one of the standard treatments for various benign and malignant disease of the pancreatic head and periampullary region and distal pancreatectomy for lesions in the tail of pancreas. (sagepub.com)
- Pancreatic fistula (PF) is the most common and challenging complication after pancreaticoduodenectomy (PD). (scipedia.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)
- 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)
- Results: Two hundred eleven patients underwent pancreaticoduodenectomy with pancreatic-enteric anastomosis, received appropriate saline/octreotide doses, and were available for endpoint analysis. (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)
- Context Pancreaticoduodenectomy (PD) is still characterized by high morbidity rates even in high volume centers, mainly represented by postoperative pancreatic fistula (POPF) and its associated further consequences. (unina.it)
- Sealing with Hemopatch® as an adjuvant after a pancreaticoduodenectomy might offer a new possibility to decrease postoperative pancreatic fistula, with fewer severe fistulas, shorter hospital stays and reduced healthcare costs. (blogspot.com)
- 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)
- The effect of preoperative biliary drainage (PBD) prior to pancreaticoduodenectomy (PD) on postoperative pancreatic fistula (POPF) is variably reported in literature. (thieme-connect.de)
- Pancreatic fistula after pancreaticoduodenectomy: the conservative treatment of choice. (medigraphic.com)
- In 1937, Brunschwig extended the indications for pancreaticoduodenectomy by performing the operation for pancreatic head lesions. (medscape.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 pancreatic head performed as a one-stage procedure, which we recognize today as the classic pancreaticoduodenectomy. (medscape.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 resection and 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)
- The diagnoses of pancreatic fistula and clinically relevant pancreatic fistula after pancreaticoduodenectomy were judged strictly by the International Study Group on pancreatic fistula definition. (wjgnet.com)
- ASO Visual Abstract: A Machine-Learning Approach to Predict Postoperative Pancreatic Fistula after Pancreaticoduodenectomy Using only Preoperatively Known Data. (ucsf.edu)
- Clinically relevant postoperative pancreatic fistula (CR-POPF) is a life-threatening complication following pancreaticoduodenectomy (PD). (hunimed.eu)
- Pancreaticoduodenectomy Among Patients With Pancreatic Ductal Adenocarcinoma. (cancercentrum.se)
- 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)
POPF19
- BACKGROUND: Postoperative pancreatic fistula (POPF) is a common and serious complication after distal pancreatectomy (DP). (minervamedica.it)
- An effective and accepted score to predict the occurrence of clinically relevant (CR-) postoperative pancreatic fistula (POPF) does not exist. (minervamedica.it)
- CONCLUSIONS: An easy-to-use postoperative score based on operation time, obesity, amylase level on drains on POD3 and pancreatic thickness on preoperative CT seems to predict the risk of developing CR-POPF. (minervamedica.it)
- BACKGROUND: Post-operative pancreatic fistula (POPF) is a common and potentially life-threatening complication following pancreaticoduodectomy. (ru.nl)
- The aim of this study was to assess the predictive value of intra-operative amylase concentration (IOAC) in peri-pancreatic fluid after resection for the diagnosis of POPF. (ru.nl)
- One of the most important life-threatening complications is a postoperative pancreatic fistula (POPF) [ 4 , 5 ]. (kjco.org)
- Postoperative pancreatic fistula (POPF) is a major cause of morbidity after pancreatic surgery . (bvsalud.org)
- This approach should be considered a therapeutic option in patients with POPF after pancreatic surgery . (bvsalud.org)
- Wirsung diameter and pancreatic texture are well known features related to increased POPF risk. (unina.it)
- However, limited information about the relationship between morphological features of pancreatic stump and POPF onset is available. (unina.it)
- Objective Aim of the study was to evaluate the relationship between pancreatic stump morphology, intra-operatively assessed, and the occurrence of POPF in patients undergoing PD in an high volume center. (unina.it)
- In multivariate analysis, only pancreatic stump soft texture and Wirsung diameter smaller than 4 mm were associated with POPF. (unina.it)
- Conclusion This study confirms small Wirsung diameter and soft pancreatic texture as the main determinants for POPF development. (unina.it)
- Postoperative pancreas fistula (POPF) is a major complication after total gastrectomy with splenectomy. (biomedcentral.com)
- This study was designed to evaluate the effects of abdominal shape at the umbilicus and the upper abdomen on short-term surgical outcomes, particularly the incidence of postoperative pancreas fistula (POPF) in patients undergoing total gastrectomy with splenectomy. (biomedcentral.com)
- Why should biliary or pancreatic stenting affect the incidence of POPF? (thieme-connect.de)
- PURPOSE: The International Study Group on Pancreatic Fistula's definition of postoperative pancreatic fistula (POPF) has recently been updated. (koreamed.org)
- The secondary outcomes include postoperative major complications (Clavien-Dindo≥3), postoperative pancreatic fistula (POPF), post-pancreatectomy acute pancreatitis (PPAP), infection, and unexpected relaparotomy, as well as postoperative length of stay, 30-day mortality, and 90-day mortality. (biomedcentral.com)
- The main postoperative complications include postoperative pancreatic fistula (POPF), post-pancreatectomy hemorrhage (PPH), and delayed gastric emptying (DGE). (biomedcentral.com)
Ductal adenocarcinoma1
- Impact of intensified chemotherapy in metastatic pancreatic ductal adenocarcinoma (PDAC) in clinical routine in Europe. (cancercentrum.se)
Clinically1
- Results Pancreatic fistula occurred in 19 cases (23.8%), 10 of them clinically significant (grade B and C according to ISGPF classification). (unina.it)
Complications6
- Most of these complications are related to pancreatic fistula, with serious complications of intra-abdominal abscess, postoperative bleeding, and multiorgan failure. (sagepub.com)
- Pancreatic fistula (PF) hence has been one of the major complications discouraging surgeons from performing PD. (sagepub.com)
- The primary postoperative endpoints were pancreatic fistula, total complications, death, and length of hospital stay. (arizona.edu)
- Moreover, postoperative pancreatic complications are difficult to treat and prolong hospitalization. (biomedcentral.com)
- Possible complications include dilatation, distortion and stricture of the pancreatic ducts, calcification of the pancreatic parenchyma, formation of pseudocysts, duodenal or common bile duct stenosis, or the formation of superior mesenteric, portal or splenic vein thrombosis which may each severely affect the patient's quality of life and overall prognosis ( 1 , 6 ). (iiarjournals.org)
- What are the Complications of Pancreatic Injury? (autoaccident.com)
Anastomosis4
- The two groups were comparable with respect to demographics (54% male, median age 66 years), type of pancreaticoduodenal resection (60% pylorus-preserving), type of pancreatic-enteric anastomosis (87% end-to-side pancreaticojejunostomy), and pathologic diagnosis. (arizona.edu)
- Moreover, an higher risk of failure of pancreatic anastomosis is also observed in large pancreatic stumps and when main pancreatic duct is centrally located. (unina.it)
- We need more such studies from other centers to confirm that the rare event of preoperative biliary and pancreatic stenting has indeed this harmful effect on healing of postoperative pancreatic anastomosis. (thieme-connect.de)
- Pancreatic-enteric anastomosis has remained a true Achilles' heel in this complex and technically demanding operation. (biomedcentral.com)
Pancreas10
- A pancreatic fistula is an abnormal communication between the pancreas and other organs due to leakage of pancreatic secretions from damaged pancreatic ducts. (wikipedia.org)
- An external pancreatic fistula is an abnormal communication between the pancreas (actually pancreatic duct) and the exterior of the body via the abdominal wall. (wikipedia.org)
- Exocrine pancreatic insufficiency (EPI) is an inability of proper digestion of food owing to insufficient levels of digestive enzymes from pancreas. (researchandmarkets.com)
- Chronic pancreatitis (CP) is a progressively evolving inflammation of the pancreas along with destruction of the pancreatic parenchyma and its replacement by fibrotic tissue that results in progressive loss of endocrine and exocrine functionality ( 1 ). (iiarjournals.org)
- Conversely, studies indicate that the most injured pancreatic region is the body of the pancreas. (autoaccident.com)
- SPPT) is a rare exocrine pancreatic neoplasm, tumor' of the pancreas.4 not conflict of interests. (bvsalud.org)
- The lower (terminal) part of the CBD runs behind (or sometimes through) the upper half of the head of pancreas before it joins the main pancreatic duct (MPD) to form a common channel (ampulla). (medscape.com)
- The pancreatic neck is the arbitrary junction between the head and body of the pancreas. (medscape.com)
- Because the pancreas lies obliquely, all parts of the pancreas are not at the same transverse level and are not seen in 1 section (cut) of the CT scan-the pancreatic head is lower (at the level of L2) than its body (L1) and tail (T12). (medscape.com)
- The normal pancreatic duct may be just seen in the head (3-4 mm) and proximal body (2-3 mm) of the pancreas on CT scan. (medscape.com)
Incidence4
- Purpose: To evaluate the incidence, predictors and clinical outcome of pancreatic fistulas in patients receiving splenectomy during cytoreductive surgery for advanced or recurrent ovarian cancer. (unicatt.it)
- Results of the Monte Carlo simulation determined: the incidence of postoperative pancreatic fistula in the Hemopatch® group reported was 7.7% vs 30.9% (p value: 0.05), biliary fistula 7.7% vs 15.4% (p value: 0.05), hemorrhage 7.7% vs 15.5% (p value: 0.05), mean stay 20.8 vs 26.3 days (p value: 0.01), ICU stay 7.1 vs 9.1 days (p value: 0.01). (blogspot.com)
- The high incidence of incidental pancreatic adenocarcinoma especially underlines the necessity for an early surgical therapeutic approach for these patients. (iiarjournals.org)
- In addition, CP is considered a risk factor for pancreatic cancer, whereas the overall incidence of cancer occurrence remains unspecified ( 7 , 8 ). (iiarjournals.org)
Pancreatectomy2
- p-value = 0.012) was identified as the only independent predictor of the occurrence of pancreatic fistulas in those receiving additional distal pancreatectomy. (unicatt.it)
- Conclusion: HIPEC was identified as a risk factor for pancreatic fistulas in patients who underwent splenectomy alone, while concomitant cholecystectomy was the only independent predictor of fistula in those receiving additional pancreatectomy. (unicatt.it)
Adenocarcinoma2
- Results Sixty-two patients underwent biliary stenting alone, 5 patients underwent both biliary and pancreatic stenting, and 237 patients were not stented in the adenocarcinoma group without chronic pancreatitis. (thieme-connect.de)
- Prognostic indicators for survival after resection of pancreatic adenocarcinoma. (medigraphic.com)
Resections5
- Patients and Methods: Overall, 252 consecutive pancreatic resections for suspected chronic pancreatitis were performed at the two institutions between 2005 and 2015. (iiarjournals.org)
- Results: Pancreatic resections were performed in 193 male (76.6%) and 59 female patients (23.4%), with a median age of 53.2 years. (iiarjournals.org)
- A total of 175 resections of the pancreatic head (69.4%), 37 distal pancreatectomies (14.7%), 23 total pancreatectomies (9.1%) and 18 other pancreatic resections (7.1%) were performed within our study period. (iiarjournals.org)
- Conclusion: The results of our study demonstrate that pancreatic resections for chronic pancreatitis may nowadays be considered technically feasible and safe. (iiarjournals.org)
- Does Preoperative Estimated Glomerular Filtration Rate (eGFR) Predict Short-Term Surgical Outcomes in Patients Undergoing Pancreatic Resections? (arizona.edu)
Surgery9
- Pancreatic fistulas can be caused by pancreatic disease, trauma, or surgery. (wikipedia.org)
- Pancreatic surgery is challenging and associated with high morbidity. (kjco.org)
- Impact of endoscopic ultrasound-guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery. (bvsalud.org)
- Although the median length of hospital stay was higher in women with pancreatic leakage (p-value = 0.008), the median time from surgery to adjuvant treatment was not significantly increased. (unicatt.it)
- Cristina Ridolfi Pancreatic Surgery Division, IRCCS "Humanitas" Clinical Institute. (unina.it)
- A Simple Classification of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery. (nih.gov)
- Conservative treatment or surgery may be indicated depending on the grade of pancreatic trauma. (autoaccident.com)
- The morbidity and mortality rate may increase significantly without surgery within 24 hours in severe pancreatic injury cases. (autoaccident.com)
- Global Audits on Pancreatic Surgery Group (GAPASURG). (cancercentrum.se)
Cancer11
- The artery first approach for resection of pancreatic head cancer. (medigraphic.com)
- See also Ampullary Carcinoma , Pancreatic Cancer , Pancreatic Trauma , and Carcinoma of the Ampulla of Vater . (medscape.com)
- Recommendations for screening of patients with CP for pancreatic cancer do not exist and, due to a wide diversity of clinical and morphological presentations of CP, the differentiation between CP and pancreatic cancer, especially in cases when malignant tumor growth appears in the course of CP, is challenging ( 4 ). (iiarjournals.org)
- Single-nucleus and spatial transcriptome profiling of pancreatic cancer identifies multicellular dynamics associated with neoadjuvant treatment. (nih.gov)
- He focuses on the operative management of pancreatic cancer, liver cancer, gallbladder disease and metastases to the liver and abdominal peritoneum. (columbiasurgery.org)
- Robotic Appleby modified procedure for locally advanced pancreatic cancer (with video). (canceropole-est.org)
- Management and Outcomes of Pancreatic Cancer in French Real-World Clinical Practice. (canceropole-est.org)
- Risk factors and outcomes for patients with pancreatic cancer undergoing surgical exploration without resection due to metastatic disease: A national cohort study. (cancercentrum.se)
- Nationwide trends and outcomes of neoadjuvant chemotherapy in pancreatic cancer - an analysis of the Swedish national pancreatic cancer registry. (cancercentrum.se)
- High resection rate improves overall survival in elderly patients with pancreatic head cancer - A cohort study. (cancercentrum.se)
- First results from the Swedish National Pancreatic and Periampullary Cancer Registry. (cancercentrum.se)
Computed tomography1
- Pancreatic-protocol computed tomography (CT) with thin collimation will detect anatomic contraindications for surgical resection. (medscape.com)
Main panc5
- in a subgroup composed by 72 cases we realized a prospective study recording intra-operative measurements of the remnant pancreatic stump, recording surgeon's judgment about pancreatic texture, and highlighting the caliber of main pancreatic duct, its position and the whole area. (unina.it)
- Between March 2011 and June 2012, in a consecutive series of 72 PD, we prospectively recorded the following characteristics of the pancreatic stump: surgeon's judgment about pancreatic texture, diameter of main pancreatic duct, the whole area of pancreatic section (approximately calculated as elliptic), the distance between Wirsung duct and cranio-caudal and antero-posterior margins. (unina.it)
- METHODS: We show the case of a 24 years-old male with a 10 years length history of CP, chronic abdominal pain and dilated main pancreatic duct with a diameter of 34mm. (sages.org)
- The ventral bud rotates dorsally and fuses with the dorsal bud, and the duct of the distal part (body and tail) of the dorsal bud unites with the duct of the ventral bud to form the main pancreatic duct (of Wirsung). (medscape.com)
- Because the common bile duct (CBD) also arises from the ventral bud, it forms a common channel with the main pancreatic duct. (medscape.com)
Multivariate analysis2
- Based on multivariate analysis results, a 4 points score was created by assigning 1 point if operation time was >4 hours, amylase levels on drains' fluid >500 UI on POD 3, pancreatic thickness >10 mm and if the BMI was >30. (minervamedica.it)
- By univariate and multivariate analysis using Firth logistic regression, pancreatic texture (OR = 1.205, CI = 0.103-2.476, p = 0.032) and the presence of a biliary and pancreatic stent (OR = 2.695, CI = 0.273-7.617, p = 0.027) were the significant factors affecting pancreatic fistula. (thieme-connect.de)
Leakage5
- They may also be caused by leakage from a pancreatic pseudocyst. (wikipedia.org)
- Anterior disruption of a pseudocyst or a pancreatic duct leads to leakage of pancreatic secretions into the free peritoneal cavity, leading to pancreatic ascites. (wikipedia.org)
- 1976), internal pancreatic fistulas can result in pancreatic ascites, mediastinital pseudocysts, enzymatic mediastinitis, or pancreatic pleural effusions, depending on the flow of pancreatic secretions from a disrupted pancreatic duct or leakage from a pseudocyst. (wikipedia.org)
- Several studies reported leukocytosis on postoperative day (POD) 4 or 5 is related with pancreatic anastomotic leakage after PD [ 13 ]. (kjco.org)
- The development of pancreatic leakage was not associated with increased post-operative mortality or delay in the initiation of chemotherapy. (unicatt.it)
Underwent4
- Aim: In this study, we aimed to determine the clinical value and prognostic significance of neutrophil / lymphocyte ratio in predicting pancreatic fistula in patients who underwent pancreatoduodenectomy due to periampullary tumor.Material and Methods: Patients who underwent pancreatoduodenectomy for periampullary tumor between 2010-2019 were included in the study. (annalsmedres.org)
- The pancreatic fistula rate was similar in the patients who underwent biliary stenting alone when compared with the group which was not stented. (thieme-connect.de)
- However, the patients who underwent both biliary and pancreatic stenting had a significant increase in postoperative pancreatic fistula compared with the not stented ( p = 0.003). (thieme-connect.de)
- The aim of this study was the bi-national analysis of patients who underwent pancreatic resection for suspected chronic pancreatitis at an Austrian and a German high-volume center with regard to overall postoperative outcome and incidental carcinoma sequence. (iiarjournals.org)
Biliary3
- Simultaneous biliary and pancreatic drainage is rarely performed for very selected indications and its effects on postoperative pancreatic fistula are largely unknown. (thieme-connect.de)
- Conclusion Preoperative biliary drainage alone has no significant influence on postoperative pancreatic fistula except when combined with pancreatic stenting. (thieme-connect.de)
- After the demanding resection, pancreatic-enteric, biliary-enteric, and gastrojejunal anastomoses are required to complete digestive tract reconstruction. (biomedcentral.com)
Amylase1
- Primarily, these pancreatic digestive enzymes include lipase for the fat digestion, protease for the protein digestion, and amylase for the starch digestion in the body. (researchandmarkets.com)
Mortality2
- The single most significant cause of morbidity and mortality after PD is the development of pancreatic leak and fistula. (sagepub.com)
- 1 Pancreatic fistula (PF) is the most devastating postoperative complication occurring in 2.5-25% patients, 2 and has become the main reason for increased morbidity and mortality, prolonged length of hospital stay, and increased medical costs. (scipedia.com)
Complication1
- Each trial reported significant decreases in overall complication rates, and two of the four reported significantly lowered rates of pancreatic fistula in patients receiving prophylactic octreotide. (arizona.edu)
Tumor2
- Estudio retrospectivo que incluy a los pacientes con tumor periampular en quienes se realiz una pancreatoduodenectom a (PDD) en el HRAEPY entre enero de 2011 y junio de 2014. (medigraphic.com)
- Pancreatoblastoma is a malignant exocrine pancreatic tumor that is usually present in childhood. (koreamed.org)
Operative1
- Postcreaticoduodenectomy operative pancreatic fistula: an international study group (ISGPF) definition. (medigraphic.com)
Parenchyma2
- BACKGROUND: Chronic pancreatitis (CP) is characterized by irreversible damage of pancreatic parenchyma leading to exocrine insufficiency, intractable pain and progressive loss of endocrine function. (sages.org)
- Treatment will be individualized based on patient stability, trauma site, parenchyma involvement, the severity of damage to the pancreatic duct, and associated injuries. (autoaccident.com)
Decrease3
- Patients with postoperative fistula grades B and C showed WBC counts that did not decrease on subsequent measurements during the early postoperative period. (kjco.org)
- Several pharmacological and technical interventions have been suggested to decrease the pancreatic fistula rate, but the results have been controversial. (sagepub.com)
- Surgical procedures such as total gastrectomy with splenectomy should be very carefully executed in obese patients or patients with a deep abdominal cavity to decrease the risk of postoperative pancreatic fistula. (biomedcentral.com)
Classification1
- This paper considers definition and classification of pancreatic fistula, risk factors, and preventive approach and offers management strategy when they do occur. (sagepub.com)
Drainage2
- Recently, endoscopic ultrasound-guided transmural drainage (EUS-TD) has been widely used to manage pancreatic pseudocysts after acute pancreatitis . (bvsalud.org)
- RESULTS: Randomized trials suggest thst surgical drainage of pancreatic duct in CP is more effective than endoscopic treatment. (sages.org)
Disruption2
- Internal pancreatic fistulas are most commonly caused by disruption of the pancreatic duct due to chronic pancreatitis. (wikipedia.org)
- However, a disruption of the pancreatic duct generally indicates surgical intervention. (autoaccident.com)
Abdominal3
- When an individual suffers an abdominal injury , they may experience symptoms indicative of pancreatic trauma. (autoaccident.com)
- The signs of a pancreatic injury may include abdominal bruising, nausea, pain in the abdomen, and vomiting. (autoaccident.com)
- Se trata de una mujer de 26 años que presentó dolor en epigastrio e hipocondrio izquierdo, con aumento del perÃmetro abdominal y pérdida de 5 kg de peso corporal. (bvsalud.org)
Parenchymal1
- The pancreatic head constitutes about 50% and the body and tail the remaining 50% of the pancreatic parenchymal mass. (medscape.com)
Morphological1
- Radiomic and morphological features extracted from CT scans related to pancreatic anatomy and patient characteristics were included as variables. (hunimed.eu)
Endoscopic1
- The Role of Endoscopic Ultrasound-Guided Ki67 in The Management of Non-Functioning Pancreatic Neuroendocrine Tumors. (columbiasurgery.org)
Surgical2
- Is Surgical Management Necessary for Pancreatic Trauma? (autoaccident.com)
- Surgical exploration without resection in pancreatic and periampullary tumours: report from a national database. (cancercentrum.se)
Chronic1
- Once in the mediastinum, the secretions can either be contained in a mediastinal pseudocyst, lead to enzymatic mediastinitis, or, more commonly, leak through the pleura to enter the chest and form a chronic pancreatic pleural effusion. (wikipedia.org)