Combined minimaly invasive surgery of pancreaticolithiasis in combination with congenital stricture of the terminal sections of the pancreatic ducts

2017 ◽  
Vol 8 (5) ◽  
pp. 96-102
Author(s):  
Mikhail P. Korolev ◽  
Leonid E. Fedotov ◽  
Ruben G. Avanesyan ◽  
Elena A. Mikhailova ◽  
Georgiy M. Lepekhin ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Magnetic Resonance ◽  
Minimally Invasive ◽  
Pancreatic Duct ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Pancreatic Ducts ◽  
Invasive Treatment ◽  
Percutaneous Access ◽  
Joint Application

Chronic pancreatitis with pancreatic hypertension is extremely rare in childhood. Chronic pancreatitis in this age is usually always associated with a сongenital defect of the pancreatic duct system. The article describes the case of long-term clinical observation and minimally invasive treatment of chronic calculous pancreatitis, first diagnosed in a girl at the age of 16 years. Despite the fact that clinical manifestations were observed from the age of 3 years, the correct diagnosis could be made only at the age of 16, by joint application of ultrasound, Magnetic Resonance Imaging (MRI) and Magnetic Resonance Cholangiopancreatography (MRCP). The cause of chronic pancreatitis were concrements and strictures of the main and additional pancreatic ducts that caused pancreatic hypertension. Attempt of endoscopic retrograde lithoextraction from the pancreatic ducts was impossible because of the presence of severe stricture. Therefore, it was decided to apply a combined approach using percutaneous access under ultrasound navigation. The patient underwent series of minimally invasive combined procedures including the lithoextraction, balloon dilatation and transcutaneous drainage of the pancreatic ducts with the endoscopic and percutaneous access with ultrasound and radiologic control. For the prevention of restenosis, the antegrade stenting of the main pancreatic duct with self-expanding coated nitinol stent was used with further removal of the stent. Due to the treatment, there was no pancreatitis within 5 years after stent removal.

scholarly journals Staged surgical treatment of the patient with chronic pancreatitis

2021 ◽  
Vol 26 (3) ◽  
pp. 149-155
Author(s):  
N. Yu. Kokhanenko ◽  
A. V. Glebova ◽  
O. G. Vavilova ◽  
A. A. Kashintsev ◽  
S. A. Kaliuzhnyi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Clinical Case ◽  
Minimally Invasive Treatment ◽  
Gastric Fistula ◽  
Invasive Treatment ◽  
Head Of The Pancreas ◽  
Staged Treatment

A clinical case of successful surgical treatment of a patient with chronic pancreatitis, complicated by suppuration of a postnecrotic cyst and the formation of a cysto-gastric fistula. As a result of the conservative and minimally invasive treatment, the pseudocyst was drained, and the cystogastric fistula was closed. The staged treatment was completed by resection of the head of the pancreas with the formation of an anastomosis.

scholarly journals Anatomical Patterns of the Pancreatic Ductal System – A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

2019 ◽  
Vol 36 (04) ◽  
pp. 279-285
Author(s):  
Mythraeyee Prasad ◽  
Sipra Rout ◽  
Tharani Putta ◽  
Reuben Thomas Kurien ◽  
Sudipta Dhar Chowdhury ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Magnetic Resonance ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Pancreas Divisum ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Radiological Study ◽  
Ductal System ◽  
Type Iii ◽  
Ansa Pancreatica

Abstract Introduction Morphological variants of the pancreatobiliary system can predispose to chronic pancreatitis. The goal of the present study is to assess the prevalence of pancreatic duct patterns in the Indian population, both by cadaveric dissection and by magnetic resonance cholangiopancreatography (MRCP). Materials and Methods A total of 15 adult pancreas specimens of unknown age and gender, and 5 fetal pancreas specimens of different gestational ages with the intact second part of duodenum, were dissected by the piecemeal method. For clinical relevance, MRCP images of 103 clinically-diagnosed chronic pancreatitis patients irrespective of their etiology were obtained retrospectively from the existing database and studied. The anatomical patterns were classified as five different types based on the course of the main pancreatic duct and the accessory pancreatic duct and their openings into the duodenal wall, including variants like pancreas divisum and ansa pancreatica. Results In the cadaveric study, the main pancreatic duct was single with a straight course in 46.67% of the adult specimens, and in the MRCP study, the main pancreatic duct showed a descending course in 77.66% of the cases. The most common pattern was type III in both the cadaveric (80%) and radiological (55.33%) studies, and the accessory duct was absent on the MRCP in all type-III cases, while it ended blindly in the cadaveric specimens. Ansa pancreatica (type V) was observed in 1 adult specimen (6.7%), but not in the radiological study. Pancreas divisum (type IV) was observed in the 8 cases (7.76%) cases in the radiological study. Conclusion Knowledge of the anatomical variants of the pancreatic ductal system may be helpful for the radiologists during diagnostic and therapeutic interventional procedures.

110 O - Magnetic resonance imaging guided minimally invasive treatment of breast cancer

1996 ◽  
Vol 32 ◽  
pp. S22
Author(s):  
H. Mumtaz ◽  
M.W. Kissin ◽  
M.A. Hall-Craggs ◽  
T. Davidson ◽  
I. Taylor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Minimally Invasive ◽  
Minimally Invasive Treatment ◽  
Resonance Imaging ◽  
Invasive Treatment

scholarly journals Motion - Pancreatic Endoscopy is Useful for the Pain of Chronic Pancreatitis: Arguments for the Motion

2003 ◽  
Vol 17 (1) ◽  
pp. 57-59
Author(s):  
Stanley M Branch
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Endoscopic Therapy ◽  
Clinical Problem ◽  
Pancreatic Pseudocysts ◽  
Pancreatic Ducts ◽  
Success Rates ◽  
Long Term Follow Up

Pain is the dominant clinical problem in patients with chronic pancreatitis. It can be due to pseudocysts, as well as strictures and stones in the pancreatic ducts. Most experts agree that obstruction could cause increased pressure within the main pancreatic duct or its branches, resulting in pain. Endoscopic therapy aims to alleviate pain by reducing the pressure within the ductal system and draining pseudocysts. Approaches vary according to the specific nature of the problem, and include transgastric, transduodenal and transpapillary stenting and drainage. Additional techniques for the removal of stones from the pancreatic duct include extracorporeal shockwave lithotripsy. Success rates for stone extraction and stenting of strictures are high in specialized centres that employ experienced endoscopists, but pain often recurs during long term follow-up. Complications include pancreatitis, bleeding, infection and perforation. In the case of pancreatic pseudocysts, percutaneous or even surgical drainage should be considered if septae or large amounts of debris are present within the lesion. This article describes the techniques, indications and results of endoscopic therapy of pancreatic lesions.

scholarly journals Nodular Regenerative Hyperplasia of Liver Mimicking Cirrhosis: a Case Report

2013 ◽  
Vol 2 (3) ◽  
pp. 137-140
Author(s):  
Rui-dan Zheng ◽  
Zhuo-ran Chen ◽  
Jian-neng Chen ◽  
Hui-yong Zhang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Liver Biopsy ◽  
Sinus Bradycardia ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Nodular Regenerative Hyperplasia ◽  
Resonance Imaging ◽  
Abdominal Ultrasonography ◽  
Pathologic Features

Abstract A 34-year-old man with no history of any abdominal pain or fatigue was admitted to our hospital in June 2008 due to the cirrhosis found incidentally during a physical examination. Laboratory examination, electrocardiograph, abdominal ultrasonography and magnetic resonance imaging were carried out during his hospitalization. However, according to the results of the above measures, the diagnosis of nodular regenerative hyperplasia of the liver (NRHL) could not be made. The result of electrocardiograph showed there was no sinus bradycardia. The abdominal ultrasonography showed evidence of hepatosplenomegaly, and magnetic resonance imaging showed multiple non-enhancing hepatic nodules. Histologic confirmation was available by means of liver biopsy and the definitive diagnosis of NRHL was confirmed histologically by liver biopsy. NRHL always presents with signs of portal hypertension with little evidence of obvious liver disease, NRHL may mimick the cirrhosis of liver and be easily confused with cirrhosis of the liver nodules, so liver biopsy should be recommended for correct diagnosis. We here report the clinical, radiological and pathologic features of this case with NRHL in order to familiarize the physicians with its clinical manifestations.

Long-Term Results of Minimally Invasive Treatment for Chronic Pancreatitis

Pancreas ◽  
2010 ◽  
Vol 39 (5) ◽  
pp. 694
Author(s):  
Mitsuharu Fukasawa ◽  
Hiroyuki Maguchi ◽  
Kuniyuki Takahashi ◽  
Akio Katanuma ◽  
Manabu Osanai ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Minimally Invasive ◽  
Minimally Invasive Treatment ◽  
Long Term Results ◽  
Invasive Treatment

scholarly journals Utilizing of MRCP/MRI in differentiation between benign and malignant biliary obstruction

2018 ◽  
Vol 9 (1) ◽  
pp. 51
Author(s):  
Amjaad Majeed Hameed
Keyword(s):  
Magnetic Resonance ◽  
Strong Correlation ◽  
Biliary Obstruction ◽  
Correct Diagnosis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Abdominal Ultrasound ◽  
Final Diagnosis ◽  
Pancreatic Ducts ◽  
Biliary Dilatation

Obstruction is one of the most common problems in biliary tree pathology, combined magnetic resonance imaging (MRI) and Magnetic Resonance Cholangiopancreatography (MRCP) regarded as accurate imaging modalities in diagnosis the cause of obstruction and treatment planning due to information obtain from MRCP about biliary and pancreatic ducts, information obtains from MRI cross sections about surrounding parenchyma. This study was aimed to investigate the efficacy of combined MRCP and MRI in differentiation between benign and malignant causes of biliary dilatation and their sensitivity in detection specific cause of biliary dilatation. This study involved 72 patients and conducted in Al-Diwaniyah Teaching Hospital, Iraq during a period from February 2013 to June 2017, the diagnosis of biliary dilatation was done by abdominal ultrasound to all patients followed by MRCP/MRI, the results of MRCP/MRI was compared with final diagnoses done by endoscopic retrograde cholangiopancreatography (ERCP), surgical, histopathological and laboratory results. The results revealed that a strong correlation between MRCP/MRI and other gold standard tools in differentiation between benign and malignant causes of obstruction. Sensitivity, specificity, and accuracy of MRCP in differentiation between malignant and benign causes of biliary dilatation were 98.4%, 100% & 99.7% respectively. There was a strong correlation (0.990) between MRCP/MRI & final diagnosis to determine the specific cause of obstruction, correct diagnosis the cause of obstruction in 68 patients out of 72 with a sensitivity of 94%. This study concluded that combined MRCP/MRI plays an important role in differentiation benign & malignant causes of biliary obstruction and in differentiation the specific cause of obstruction. Keywords: MRI; MRCP; Biliary obstruction; ERCP

scholarly journals The Use of Neoprene in Experimental Pancreatitis

2019 ◽  
Vol 70 (2) ◽  
pp. 676-678
Author(s):  
Alexandru Grigorovici ◽  
cristian Velicescu ◽  
Delia Hinganu ◽  
Alina Calin ◽  
Marius Valeriu Hinganu ◽  
...  
Keyword(s):  
Experimental Study ◽  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Genetically Modified ◽  
Pancreatic Tissue ◽  
Experimental Pancreatitis ◽  
Pancreatic Ducts ◽  
Genetically Modified Animals

The concept of chronic pancreatitis has been stated in our country much later than acute pancreatitis. This manuscript proposes a synthesis of the etiopathogenic, diagnostic and therapeutic data in chronic pancreatitis based on actual information correlated with the results of our experimental study. The experiment was conducted on 18 animals, in which was performed the intraduodenal ligation of the pancreatic duct apertures and the obstruction of the pancreatic ducts with intraparenchymatous, intraoperative neoprene injections. We investigated the lesions by using intraoperative pancreatic tissue collected after injections. The results encourage us to continue the research and to choose genetically modified animals because are closer to the human one.

scholarly journals A novel minimally invasive approach for chronic pancreatitis: combination of Frey procedure and laparoscopic distal pancreatectomy

2020 ◽  
Author(s):  
Kenta Saito ◽  
Yoichi Matsuo ◽  
Goro Ueda ◽  
Kan Omi ◽  
Yuichi Hayashi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Open Approach ◽  
Minimally Invasive Approach ◽  
Severe Stenosis ◽  
Invasive Approach ◽  
Frey Procedure

Abstract Background: The treatment of chronic pancreatitis requires a surgical approach in patients refractory to medical therapy. During surgical treatment, ductal decompression is required, but a pancreatectomy is necessary for some patients, such as those with severe stenosis of the pancreatic duct. Importantly, inadequate procedures lead to recurrent pancreatitis. We used a novel minimally invasive approach for patients with severe stenosis of the pancreatic duct. In this report, we aim to present the feasibility and outcomes of our approach. Methods: We selected a laparoscopic approach for the distal pancreatectomy because these parts are relatively safe and the effect of reducing the length of the wound is substantial. We selected an open approach for parts of the Frey procedure because complete ductal compression has a high risk for injury to the vessels posterior to the pancreas. We examined operative outcomes, postoperative complications and recurrence of pancreatitis.Results: Our approach was performed in three patients from January 2018 to December 2018. No intraoperative complications occurred and the postoperative course was uneventful in all patients. There were no recurrence of pancreatitis and no postoperative pain in all patients in the over two years follow-up. Conclusion: Our hybrid method focusing on complete ductal compression with safety and minimal invasiveness is the optimal approach for the surgical treatment of chronic pancreatitis which requires a pancreatectomy with the Frey procedure.

scholarly journals A novel minimally invasive approach for chronic pancreatitis: combination of Frey procedure and laparoscopic distal pancreatectomy

2020 ◽  
Author(s):  
Kenta Saito ◽  
Yoichi Matsuo ◽  
Goro Ueda ◽  
Kan Omi ◽  
Yuichi Hayashi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Open Approach ◽  
Minimally Invasive Approach ◽  
Severe Stenosis ◽  
Invasive Approach ◽  
Frey Procedure

Abstract Background The treatment of chronic pancreatitis requires a surgical approach in patients refractory to medical therapy. During surgical treatment, ductal decompression is required, but a pancreatectomy is necessary for some patients, such as those with severe stenosis of the pancreatic duct. Importantly, inadequate procedures lead to recurrent pancreatitis. We used a novel minimally invasive approach for patients with severe stenosis of the pancreatic duct. In this report, we aim to present the feasibility and outcomes of our approach. Methods We selected a laparoscopic approach for the distal pancreatectomy because these parts are relatively safe and the effect of reducing the length of the wound is substantial. We selected an open approach for parts of the Frey procedure because complete ductal compression has a high risk for injury to the vessels posterior to the pancreas. We examined operative outcomes, postoperative complications and recurrence of pancreatitis. Results Our approach was performed in three patients from January 2018 to December 2018. No intraoperative complications occurred and the postoperative course was uneventful in all patients. There were no recurrence of pancreatitis and no postoperative pain in all patients in the over 18 months follow-up. Conclusion Our hybrid method focusing on complete ductal compression with safety and minimal invasiveness is the optimal approach for the surgical treatment of chronic pancreatitis which requires a pancreatectomy with the Frey procedure.

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