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Pancreas anatomy

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https://www.readbyqxmd.com/read/28934821/feasibility-of-a-complete-pancreatobiliary-linear-endoscopic-ultrasound-examination-from-the-stomach
#1
Vinay Dhir, Douglas G Adler, Nonthalee Pausawasdi, Amit Maydeo, Khek Yu Ho
Background and study aims Linear endoscopic ultrasound (EUS) evaluation of the pancreaticobiliary system usually requires scanning from both the stomach and the duodenum. The feasibility of assessing the complete pancreaticobiliary system from the stomach alone has not been studied. We aimed to conceptualize a system-based approach (the railroad approach) for linear pancreaticobiliary EUS (PB-EUS) and evaluate whether the pancreaticobiliary anatomy could be assessed from the stomach alone. Patients and methods Three maneuvers were conceptualized and evaluated (the alpha maneuver in the stomach, and sigma and xi maneuvers in the duodenum)...
September 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28872120/dissection-of-the-mouse-pancreas-for-histological-analysis-and-metabolic-profiling
#2
Michelle J Veite-Schmahl, Daniel P Regan, Adam C Rivers, Joseph F Nowatzke, Michael A Kennedy
We have been investigating the pancreas specific transcription factor, 1a cre-recombinase; lox-stop-lox- Kristen rat sarcoma, glycine to aspartic acid at the 12 codon (Ptf1a(cre/+);LSL-Kras(G12D/+)) mouse strain as a model of human pancreatic cancer. The goal of our current studies is to identify novel metabolic biomarkers of pancreatic cancer progression. We have performed metabolic profiling of urine, feces, blood, and pancreas tissue extracts, as well as histological analyses of the pancreas to stage the cancer progression...
August 19, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28871557/anatomy-of-the-transverse-mesocolon-based-on-embryology-for-laparoscopic-complete-mesocolic-excision-of-right-sided-colon-cancer
#3
Takeru Matsuda, Yasuo Sumi, Kimihiro Yamashita, Hiroshi Hasegawa, Masashi Yamamoto, Yoshiko Matsuda, Shingo Kanaji, Taro Oshikiri, Tetsu Nakamura, Satoshi Suzuki, Yoshihiro Kakeji
BACKGROUND: To treat colon cancer via complete mesocolic excision (CME) with central vascular ligation (CVL), dissection along the embryologic fusion planes is required. However, this surgery is difficult, especially for right-sided colon cancer, because the anatomy and embryology of the transverse mesocolon are not familiar to gastrointestinal surgeons. METHODS: In this video article, the anatomic details of the transverse mesocolon based on embryology are illustrated with a focus on the venous anatomy...
September 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28871465/the-crossing-duct-sign
#4
REVIEW
Yan-Lin Li, Man-Leung Yu, Kam-Ho Lee
Pancreas divisum is a common variation in pancreatic ductal anatomy present in up to 10% of the population with variable clinical importance. The crossing duct sign refers to the appearance of dominant dorsal duct crossing the intrapancreatic common bile duct to empty into the minor papilla, best illustrated on maximum intensity projection images from MRCP.
September 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28836242/-discussion-on-standardized-implementation-of-laparoscopic-radical-lymphadenectomy-for-distal-gastric-cancer
#5
Zejian Lyu, Junjiang Wang, Yong Li
Laparoscopic radical gastrectomy for gastric cancer has been widely applied in clinical practice, and its indications have been extended from early gastric cancer to advanced gastric cancer. It is acknowledged that laparoscopic radical gastrectomy is technically challenging because of the complexity of anatomy, rich blood supply, and extensive lymph node dissection. This paper primarily intends to share the experience of laparoscopic radical D2 gastrectomy for distal gastric cancer with details of choosing the location of Trocar, surgical approaches and the sequence of lymph node dissection...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28836239/-reconsideration-of-hot-topics-on-laparoscopic-radical-gastrectomy
#6
Lu Zang, Junjun Ma, Minhua Zheng
Laparoscopic radical gastrectomy(LRG) has been popularized with the development of laparoscopic surgical techniques. As a result of the requirement of surgical skill of LRG, the evidence is always highly demanded. The surgical safety and radical resection of tumor is one of the most important principles. Based on published studies and authors' own experience, this article discusses the following topics on laparoscopic gastrectomy: (1)Indications of surgery: Laparoscopic gastrectomy for early gastric cancer is accepted all over the world...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28815078/surgical-anatomy-of-the-omental-bursa-and-the-stomach-based-on-a-minimally-invasive-approach-different-approaches-and-technical-steps-to-resection-and-lymphadenectomy
#7
Hylke J F Brenkman, Nicole I van der Wielen, Jelle P Ruurda, Maarten S van Leeuwen, Joris J G Scheepers, Donald L van der Peet, Richard van Hillegersberg, Ronald L A W Bleys, Miguel A Cuesta
BACKGROUND: It is imperative for surgeons to have a proper knowledge of the omental bursa in order to perform an adequate dissection during minimally invasive surgery (MIS) of the upper gastrointestinal (GI) tract. This study aimed to describe (1) the various approaches which can be used to enter the bursa and to perform a complete lymphadenectomy, (2) the boundaries and anatomical landmarks of the omental bursa as seen during MIS, and (3) whether a bursectomy should be performed for oncological reasons in upper GI cancer...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28808857/the-surgeon-s-role-in-treating-chronic-pancreatitis-and-incidentally-discovered-pancreatic-lesions
#8
Vikrom K Dhar, Brent T Xia, Syed A Ahmad
Chronic pancreatitis and incidentally discovered pancreatic lesions present significant diagnostic and therapeutic challenges for surgeons. While both decompressive and resection procedures have been described for treatment of chronic pancreatitis, optimal management must be tailored to each patient's individual disease characteristics, parenchymal morphology, and ductal anatomy. Surgeons should strive to achieve long-lasting pain relief while preserving native pancreatic function. For patients with incidentally discovered pancreatic lesions, differentiating benign, pre-malignant, and malignant lesions is critical as earlier treatment is thought to result in improved survival...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28764144/variant-anatomy-of-the-hepatic-vasculature-importance-in-hepatobiliary-resections
#9
Sarika Rachel Tigga, Sandeep Saluja, Virendra Budhiraja, Rakhi Rastogi
A variant anatomy of the hepatic vasculature has a clinically significant role in hepatobiliary transplantation, resection, tumour embolisation as well as in extrahepatic abdominal surgeries involving the stomach, pancreas or gall bladder. During routine cadaveric dissection, we observed a case of unusually small calibre hepatic artery proper. An accessory hepatic artery was seen emerging from the superior mesenteric artery to the right hepatic lobe along with an accessory hepatic vein from the right hepatic lobe that drained directly into the inferior vena cava...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#10
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
July 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28726321/the-prevalence-of-transpancreatic-common-hepatic-artery-and-coexisting-variant-anatomy
#11
Kousei Ishigami, Akihiro Nishie, Yoshiki Asayama, Yasuhiro Ushijima, Yukihisa Takayama, Daisuke Okamoto, Nobuhiro Fujita, Tomoharu Yoshizumi, Norifumi Harimoto, Takao Ohtsuka, Kohei Nakata, Hiroshi Honda
PURPOSE: We studied the prevalence of the transpancreatic common hepatic artery (tp-CHA) and coexisting variant anatomy. MATERIALS AND METHODS: The study group comprised 788 consecutive liver transplant donor candidates who had undergone thin-section multidetector-row computed tomography (MDCT) studies to investigate vascular anatomy. Multiplanar reformatted (MPR) images obtained from the arterial phase were retrospectively reviewed to assess the presence/absence of the tp-CHA...
July 20, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28634319/common-hepatic-artery-quadrifurcation-associated-with-right-hepatic-artery-from-superior-mesenteric-artery-during-laparoscopic-total-splenopancreasectomy
#12
Francesco Caruso, Giorgio Alessandri, Francesca Ciccarese, Giovanni Cesana, Matteo Uccelli, Giorgio Castello, Roberta Villa, Stefano Olmi
Hepatobiliopancreatic surgery is challenging becouse of the complexity of resections and reconstructions and variability of vascular anatomy. The arterial vascularization of the liver is susteined by the common hepatic artery (CHA) that originates from the celiac trunk (CT). The CHA bifurcates into the gastroduodenal artery (GDA) and proper hepatic artery (PHA) 0.5-1 cm medial to the common bile duct (CBD), and the PHA bifurcates into a right and a left branch at hepatic hilum. The most frequent variants are the right hepatic artery (RHA) from the superior mesenteric artery (SMA), the left hepatic artery (LHA) from the left gastric artery (LGA) or a combination of these two variants...
June 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28597678/a-giant-hiatal-hernia-and-intrathoracic-pancreas
#13
Ismael Mora-Guzmán, Juan Antonio Del Pozo Jiménez, Elena Martín-Pérez
Transhiatal herniation of the pancreas is an extremely rare condition, with only a few more than ten cases reported. Most patients are symptomatic at initial presentation and multi-detector computed tomography allows a detailed visualization of the anatomy and size of the diaphragmatic defect. Surgical repair is recommended for symptomatic cases.
June 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28523348/closed-loop-of-main-duct-of-pancreas-a-rare-variant-configuration
#14
Harsimran Jit Singh, Anjali Aggarwal, Rakesh K Kochhar, T D Yadav, Tulika Gupta, Daisy Sahni
During routine dissection, duplication of main pancreatic duct extending from body to head region of pancreas was observed in a 78-year-old formalin fixed male cadaver. Main pancreatic duct gave a prominent branch which joined back the parent duct in head resulting in the formation of a closed loop. This gave the appearance of focal duplication in the form of a closed loop, an unusual variant. This was an incidental finding. Such cases usually remain asymptomatic; however, if undetected may be the cause of postoperative pancreatic fistula following pancreaticobiliary surgery...
May 18, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28516004/endoscopic-ultrasound-reaching-where-others-can-t
#15
Fady G Haddad, Magda Daoud, Ying Liu, Sherif Andrawes
Endoscopic ultrasound (EUS) has been increasingly used for the diagnosis and staging of pancreatic cancer. It has recently become the modality of choice in assessing pancreatic lesions overcoming other traditional modalities. Typically lesions located at the tail of the pancreas are best accessed through the stomach. We present a patient with pancreatic tail mass occurring in the setting of a large hiatal hernia, intrathoracic stomach, and severe lumbar levoscoliosis. Due to altered anatomy and extensive vascular connections of the mass, any surgical or radiological intervention was considered high risk for the patient...
April 15, 2017: Curēus
https://www.readbyqxmd.com/read/28469915/theoretical-investigation-of-transgastric-and-intraductal-approaches-for-ultrasound-based-thermal-therapy-of-the-pancreas
#16
Serena J Scott, Matthew S Adams, Vasant Salgaonkar, F Graham Sommer, Chris J Diederich
BACKGROUND: The goal of this study was to theoretically investigate the feasibility of intraductal and transgastric approaches to ultrasound-based thermal therapy of pancreatic tumors, and to evaluate possible treatment strategies. METHODS: This study considered ultrasound applicators with 1.2 mm outer diameter tubular transducers, which are inserted into the tissue to be treated by an endoscopic approach, either via insertion through the gastric wall (transgastric) or within the pancreatic duct lumen (intraductal)...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28447199/a-novel-reconstruction-technique-during-pancreaticoduodenectomy-after-roux-en-y-gastric-bypass-how-i-do-it
#17
George Younan, Susan Tsai, Douglas B Evans, Kathleen K Christians
The altered anatomy in patients after bariatric surgery who have undergone a Roux-en-Y gastric bypass may pose a technical challenge for surgical removal of the pancreatic head. We treat patients with pancreas cancer with multimodality therapy in a neoadjuvant fashion followed by pancreaticoduodenectomy (PD). In patients with Roux-en-Y gastric bypass anatomy, the gastric remnant is preserved and used for pancreaticogastrostomy reconstruction and subsequently drained by the same jejunal limb used for the hepaticojejunostomy...
July 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28331142/usefulness-of-color-coding-resected-samples-from-a-pancreaticoduodenectomy-with-tissue-marking-dyes-for-a-detailed-examination-of-surgical-margin-surrounding-the-uncinate-process-of-the-pancreas
#18
Satoshi Mizutani, Hideyuki Suzuki, Takayuki Aimoto, Seiji Yamagishi, Keisuke Mishima, Masanori Watanabe, Yasuhiko Kitayama, Norio Motoda, Saiko Isshiki, Eiji Uchida
BACKGROUND: Characteristics of a cancer-positive margin around a resected uncinate process of the pancreas (MUP) due to a pancreticoduodenectomy are difficult to understand by standardized evaluation because of its complex anatomy. The purposes of this study were to subclassify the MUP with tissue marking dyes of different colors and to identify the characteristics of sites that showed positivity for cancer cells in patients with pancreatic head carcinoma who underwent circumferential superior mesenteric arterial nerve plexus-preserving pancreaticoduodenectomy...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28281726/anastomotic-loop-between-common-hepatic-artery-and-gastroduodenal-artery-in-coexistence-with-an-aberrant-right-hepatic-artery
#19
Konstantinos Natsis, Maria Piagkou, Theodosis Stamatopoulos, Ioannis Spyridakis, Stylianos Apostolidis
Anatomical variations of the hepatic arteries are not uncommon. The anomalous hepatic arterial supply is of paramount importance in hepatobiliary, pancreatic or liver transplantation and in laparoscopic surgery. We describe an unusual case of a 66-year-old Greek male cadaver, where a rare anastomosis (in the form of an enlarged arterial loop, 4.84 mm in diameter) between the common hepatic artery (6.42 mm) and the gastroduodenal artery (GDA) (4.82 mm) coexisted with an aberrant right hepatic artery (ARHA) (6...
March 10, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28241234/laparoscopic-total-pancreatectomy-with-islet-autotransplantation-and-intraoperative-islet-separation-as-a-treatment-for-patients-with-chronic-pancreatitis
#20
Caleb J Fan, Kenzo Hirose, Christi M Walsh, Michael Quartuccio, Niraj M Desai, Vikesh K Singh, Rita R Kalyani, Daniel S Warren, Zhaoli Sun, Marie N Hanna, Martin A Makary
Importance: Pain management of patients with chronic pancreatitis (CP) can be challenging. Laparoscopy has been associated with markedly reduced postoperative pain but has not been widely applied to total pancreatectomy with islet autotransplantation (TPIAT). Objective: To examine the feasibility of using laparoscopic TPIAT (L-TPIAT) in the treatment of CP. Design, Setting, and Participants: Thirty-two patients with CP presented for TPIAT at a tertiary hospital from January 1, 2013, through December 31, 2015...
June 1, 2017: JAMA Surgery
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