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Pancreas anatomy

Ankur Gupta, Praveer Rai, Vivek Singh, Rakesh Kumar Gupta, Vivek Anand Saraswat
BACKGROUND: Knowledge about anatomic variations in intrahepatic biliary ducts (IHBD) is relevant for performing biliary drainage and for avoiding bile duct injury during cholecystectomy and liver resections. Low insertion of cystic duct (LICD) is a common anatomic variant. Pancreas divisum is the commonest congenital anomaly of pancreas; it has been causally linked with recurrent acute pancreatitis (RAP). METHODS: Magnetic resonance cholangiopancreaticography (MRCP) images of 500 consecutive patients were reviewed for anatomic variants of IHBD, cystic duct, and pancreatic duct...
September 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Avik Sarkar, Ragui Sadek, Matthew Lissauer, Swati Pawa
BACKGROUND: After an acute attack of pancreatitis, walled-off pancreatic fluid collections (PFC) occur in approximately 10 % of cases. Drainage of the cavity is recommended when specific indications are met. Endoscopic drainage has been adopted as the main intervention for symptomatic walled-off PFC. Altered gastric anatomy in these patients poses an interesting challenge. We present the first case of a patient with sleeve gastrectomy who underwent successful endoscopic transduodenal necrosectomy (TDN)...
2016: BMC Obesity
Raphael Suy, Sarah Thomis, Inge Fourneau
In the seventeenth century, opportunities to discover chyle came about through the revival of vivisection. Gaspare Aselli discovered chyle vessels in a living well-fed dog in 1622. He introduced the term 'lacteals' or milky veins. According to Aselli, the lacteals passed through a mesenteric gland which he called 'pancreas'. The 1627 edition of Aselli's booklet was the start of a 'lymphomania', which led to the dissection and vivisection of hundreds of animals, with the University of Leiden being the clear leader in this field...
August 26, 2016: Acta Chirurgica Belgica
Minoru Tsuchitani, Junko Sato, Hiroko Kokoshima
As basic knowledge for evaluation of pancreatic toxicity, anatomical structures were compared among experimental animal species, including rats, dogs, monkeys, and minipigs. In terms of gross anatomy, the pancreases of dogs, monkeys, and minipigs are compact and similar to that of humans. The rat pancreas is relatively compact at the splenic segment, but the duodenal segment is dispersed within the mesentery. In terms of histology, the islet of each animal is characterized by a topographic distribution pattern of α- versus β-cells...
July 2016: Journal of Toxicologic Pathology
André G Baranski, Hwai-Ding Lam, Andries E Braat, Alexander F Schaapherder
AIM: Organ procurement errors account for almost 20% of discarded pancreatic allografts. For this reason, the anatomical significance of the dorsal pancreatic artery (DPA) was reviewed. METHODS: A strategy on dealing with an often overlooked DPA is evaluated. RESULTS: The DPA provides together with the splenic artery the main blood supply to the pancreatic tail. Three different arterial variations have been described. In the rare instances when the DPA arises from the common hepatic artery or the celiac trunk, instead of the splenic origin, the DPA can easily be overlooked by surgeons not familiar with this artery...
October 2016: Clinical Transplantation
Tom K Lin, David M Troendle, Daniel B Wallihan, Bradley Barth, Victor L Fox, Douglas S Fishman, Veronique D Morinville
OBJECTIVES: An increasing number of children are being diagnosed with pancreatitis and other pancreatic abnormalities. Dissemination of the information regarding existing imaging techniques and endoscopic modalities to diagnose and manage pancreatic disorders in children is sorely needed. METHODS: We conducted a review of the medical literature on the use of the following imaging and procedural modalities in pediatric pancreatology: transabdominal ultrasonography (TUS), computed tomography (CT), magnetic resonance imaging (MRI)- magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), endoscopic retrograde cholangiopancreatography (ERCP)...
August 6, 2016: Journal of Pediatric Gastroenterology and Nutrition
Raza Sayyed, Iffat Rehman, Imran Khalid Niazi, Muhammed Aasim Yusuf, Aamir Ali Syed, Faisal V
Aberrant hepatic arterial anatomy poses a challenge for the surgeon during Whipple procedure. Intraoperative injury to the aberrant vasculature results in hemorrhagic or ischemic complications involving the liver and biliary tree. We report a case of replaced right hepatic artery arising from the superior mesenteric artery in a patient with periampullary carcinoma of the pancreas, undergoing pancreaticoduodenectomy. The aberrant artery was found to be coursing through the pancreatic parenchyma. This is a rare vascular anomaly...
June 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Liansheng Zheng, Ce Zhang, Da Wang, Qi Xue, Xiaoping Liu, Ke-Jian Zhou, Hao Liu, Guoxin Li
BACKGROUND: The conventional radical resection of proximal gastric cancer is even more risky when performed laparoscopically, though this technique is widely used in gastrointestinal surgery and is accepted as the superior method. This paper explores the feasibility of laparoscopic spleen-preserving hilar lymph node dissection using a retro-pancreatic approach for the treatment of proximal gastric cancer. METHODS: Two cadavers were dissected for examination of and the pre-pancreatic and retro-pancreatic spaces...
2016: Cancer Cell International
Alexsander K Bressan, Jean-Francois Ouellet, Divine Tanyingoh, Elijah Dixon, Gilaad G Kaplan, Sean C Grondin, Robert P Myers, Rachid Mohamed, Chad G Ball
BACKGROUND: Low-dose ionizing radiation from medical imaging has been indirectly linked with subsequent cancer and increased costs. Computed tomography (CT) is the gold standard for defining pancreatic anatomy and complications. Our primary goal was to identify the temporal trends associated with diagnostic imaging for inpatients with pancreatic diseases. METHODS: Data were extracted from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) database from 2000 to 2008...
June 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Vinay K Kapoor
Culinary terms have been used to describe anatomy (bean-shaped kidneys), pathology (strawberry gall bladder), clinical signs (café-au-lait spots), radiological images (sausage-shaped pancreas), etc. While Indian cuisine is popular all over the world, no Indian dish finds mention in medical terminology. In intra-abdominal adhesions, sometimes, the intestinal loops are so densely adherent that it is difficult to make out proximal from distal and it is impossible to separate them without injuring the bowel resulting in spill of contents-resection is the only option (Fig...
February 2016: Indian Journal of Surgery
Akram M Shaaban, Maryam Rezvani, Marc Tubay, Khaled M Elsayes, Paula J Woodward, Christine O Menias
The complex anatomy of the retroperitoneum is reflected in the spectrum of neoplastic and nonneoplastic conditions that can occur in the retroperitoneum and appear as soft-tissue masses. The presence of fat within a retroperitoneal lesion is helpful in refining the differential diagnosis. Fat is easily recognized because of its characteristic imaging appearance. It typically is hyperechoic at ultrasonography and demonstrates low attenuation at computed tomography (-10 to -100 HU). Magnetic resonance imaging is a more ideal imaging modality because it has better soft-tissue image contrast and higher sensitivity for depicting (a) microscopic fat by using chemical shift imaging and (b) macroscopic fat by using fat-suppression techniques...
May 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
David K Meyerholz
Deficient function in the anion channel cystic fibrosis (CF) transmembrane conductance regulator is the fundamental cause for CF. This is a monogenic condition that causes lesions in several organs including the respiratory tract, pancreas, liver, intestines, and reproductive tract. Lung disease is most notable, given it is the leading cause of morbidity and mortality in people with CF. Shortly after the identification of CF transmembrane conductance regulator, CF mouse models were developed that did not show spontaneous lung disease as seen in humans, and this spurred development of additional CF animal models...
July 1, 2016: Theriogenology
George Younan, Munyaradzi Chimukangara, Susan Tsai, Douglas B Evans, Kathleen K Christians
INTRODUCTION: Variations in hepatic arterial anatomy are frequently encountered in pancreas and liver surgery. These aberrancies add technical complexity to the procedure and can result in significant patient morbidity if these vascular nuances are not recognized. PRESENTATION OF CASE: We report a case whereby a superior mesenteric artery first approach was used to locate and preserve an aberrant left hepatic artery arising from a replaced gastroduodenal artery emanating from the SMA during pancreaticoduodenectomy...
2016: International Journal of Surgery Case Reports
Eugene P DiMagno, Matthew J DiMagno
On May 16, 2015 at the invitation of the American Gastroenterological Association Institute Council E.P.D. presented a state-of-the-art lecture at Digestive Disease Week 2015. The aims were to discuss a selection of landmark papers in chronic pancreatitis (CP) that influence modern management and to conclude by suggesting some future directions. This is based on that presentation. We will specifically review the following: duct anatomy and pancreas divisum, description of chronic relapsing pancreatitis and its differentiation from recurrent acute pancreatitis and established CP (ECP), natural histories and gene discoveries of alcoholic, idiopathic and hereditary pancreatitis, development of pancreatic cancer in CP, exocrine pancreatic insufficiency and calculation of dose and delivery of enzymes, endoscopic ultrasonography, and autoimmune pancreatitis...
May 2016: Pancreas
Beth A Helmink, Rebecca A Snyder, Kamran Idrees, Nipun B Merchant, Alexander A Parikh
Successful surgical resection offers the only chance for cure in patients with pancreatic cancer. However, pancreatic resection is feasible in less than 20% of the patients. In this review, the current state of surgical management of pancreatic cancer is discussed. The definition of resectability based on cross-sectional imaging and the technical aspects of surgery, including vascular resection and/or reconstruction, management of aberrant vascular anatomy and extent of lymphadenectomy, are appraised. Furthermore, common pancreatic resection-specific postoperative complications and their management are reviewed...
April 2016: Surgical Oncology Clinics of North America
Soichi Narumoto, Ken Hayashi, Hitoshi Seki, Yasuhiro Munakata
BACKGROUND/AIMS: Pancreas-preserving resection of the bile duct has been attempted as an organ preserving procedures for the treatment of low-grade malignant neoplasms of the bile duct. The fact that the lower bile duct penetrates pancreas head to join the duodenum, makes those attempts one of the challenging procedures in biliary tract surgery. Here we present a novel and unique surgical technique for anatomically resecting lower bile duct, focusing on the anatomy of the pancreas head...
May 2015: Hepato-gastroenterology
Suhong Yu, Lesley Lawrenson, Randy Wei, Varun Sehgal, Nevine Hanna, Jeffrey Kuo, Parima Daroui, Nilam Ramsinghani, Muthana Al-Ghazi
PURPOSE: Pancreatic fiducials have proven superior over other isocenter localization surrogates, including anatomical landmarks and intratumoral or adjacent stents. The more clinically relevant dosimetric impact of image guided radiation therapy (IGRT) using intratumoral fiducial markers versus bony anatomy has not yet been described and is therefore the focus of the current study. METHODS AND MATERIALS: Using daily orthogonal kV or cone beam computed tomography (CBCT) images and positional and dosimetric data were analyzed for 12 consecutive patients treated with fiducial based IGRT and volumetric modulated arc therapy to the intact pancreas...
July 2016: Practical Radiation Oncology
Francesco Caruso, Daniele Dondossola, Gianluca Fornoni, Lucio Caccamo, Giorgio Rossi
The anatomy of hepatic arteries is one of the most variable. Accurate awareness of all the possible anatomic variations is crucial in the upper GI surgery and especially in liver and pancreas transplantation. The most frequent anatomical variants are: a replaced or accessory right hepatic artery (RHA) from the superior mesenteric artery (6.3-21 %), a replaced or accessory left hepatic artery (LHA) from the left gastric artery (LGA) (3-18 %) or a combination of these two variants (up to 7.4 %). Herein, we describe the case of a 67-year-old cadaveric organ donor who presented a RHA originating from the splenic artery (SA) associated with both a CHA originating from the celiac trunk (CT) and a LHA originating from the LGA...
September 2016: Surgical and Radiologic Anatomy: SRA
Qian Xia, Yuanbo Feng, Ting Yin, Yewei Liu, Sayuan Liang, Jianjun Liu, Linjun Tong, Gang Huang, Jie Yu, Yansheng Jiang, Uwe Himmelreich, Raymond Oyen, Yicheng Ni
OBJECTIVES: We sought to devise and test a multifunctional contrast dye agent for X-ray based digital radiography (DR) or computer tomography (CT), magnetic resonance imaging (MRI), and colored staining in ex vivo validation part of animal experiments. MATERIALS AND METHODS: The custom-formulated contrast dye namely red iodized oil (RIO) was prepared by solubilizing a lipophilic dye Oil Red O in iodized poppy seed oil (Lipiodol or LPD) followed by physicochemical characterizations...
February 2016: Microscopy Research and Technique
O Kolesnik, A Lukashenko, A Shudrak, T Golovko, G Lavryk, J Huralevych
BACKGROUND: Intraoperative ultrasound examination (IOUS) is indispensable part of modern surgical interventions in tumors of hepatopancreatobiliary zone. In this study retrospective analysis of IOUS efficiency in surgical treatment of pancreatic tumors was provided. MATERIALS AND METHODS: In the period from January 2013 till November 2015 in the National Cancer Institute IOUS was applied during 76 surgical interventions: for pancreatic head tumors--in 46 (60.5%) patients, for body/tail pancreatic tumors--in 20 (26...
December 2015: Experimental Oncology
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