1,721,039 research outputs found
[Morphological and functional evolution of the residual kidney after unilateral nephrectomy in experimental and clinical medicine. Certain onsiderations on the residual kidney of transplant donors]
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[Senile dysplasias of Vater's ampulla]
No full textAdenomiosis of Vater's papilla is an organospecific dysplastic process, clearly linked to age and not dependent on other pathological processes of the biliary axis. The reasons for which it is diagnosed in preoperative biopsies with a frequency lower than should be expected on the basis of investigations performed on cadavers are stated. In particular, pathogenetic weight is stressed as a cause of Vaterian stenosis, especially in elderly subjects cholecystectomized many years earlier
[Value of transduodenoscopic wirsungography in the diagnosis of pancreatic pseudocysts]
No full textThe radiographic pictures obtained by endoscopic wirsungraphy in a group of 24 patients suffering from pancreatic pseudocysts and subsequently examined intraoperatively by wirsungraphy and cystography are analysed and commented. Pre-operative endoscopic visualisation of the lesion was obtained in 70% of the cases. In 55% of the cases there were co-existing alterations of calibre and trend of the main pancreatic duct, chiefly attributable to chronic basic pancreatitis and to a very small extent to the pseudocystic lesion. The following are discussed: a) the diagnostic value of the endoscopic procedure, which reaches absolute values in the direct visualisation of the sac, with a power of resolution that is difficult to reach with other methods; b) the probable prognostic significance with reference to the not absolutely precluded possibilities of spontaneous regression; c) the notable usefulness of the procedure, combined with intra-operative wirsungraphy and cystography, for anatomo-topographical definition of the lesion and its relations with the ductal system, indispensable for a correct formulation of the surgical tactic
Is there a place for central pancreatectomy in pancreatic surgery?
No full textTumors located in the neck of the pancreas that are not small and superficial enough to be enucleated are usually resected with a pancreaticoduodenectomy or left splenopancreatectomy. Such operations may cause digestive disorders, glucose intolerance, and late postsplenectomy infection. Central pancreatectomy is a segmental resection whereby the cephalic stump is sutured and the distal stump anastomosed with a Roux-en-Y jejunal loop. The purpose of this study was to evaluate whether central pancreatectomy has a place in pancreatic surgery. Thirteen patients with the following tumors underwent central pancreatectomy: five endocrine tumors, one mucinous and six serous cystadenomas, and one solid cystic-papillary tumor. Mean operative time was 250 minutes. Operative mortality was zero. Complications occurred in three patients (23\%). At mean follow-up of 68 months, no recurrences were found. Postoperative oral glucose tolerance, pancreolauryl, and fecal fat excretion tests were normal in all patients. We believe that central pancreatectomy does have a place in pancreatic surgery; it is a reliable technique for benign or low-grade malignant tumors and has a surgical risk similar to that of standard operations. Its principal advantage is that it preserves pancreatic parenchyma and the anatomy of the upper gastrointestinal and biliary tract and the spleen better than pancreaticoduodenectomy or distal pancreatic and splenic resection. (J Gastrointest Surg 1998;2:509-517.
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