CONTEXT Post-pancreatectomy hemorrhage is one of the most common complications after pancreaticoduodenectomy. OBJECTIVE To evaluate the late post-pancreatectomy hemorrhage rate according to the International Study Group of Pancreatic Surgery criteria and to recognize factors related to its onset. METHODS A prospective study of 113 patients who underwent pancreaticoduodenectomy was conducted...

CONTEXT Neuroendocrine tumors of the pancreatic ampulla are uncommon. The final diagnosis is based on histology, and at times, it may be difficult to diagnose them pre-operatively since they present with a similar clinical picture to adenocarcinomas of this region. OBJECTIVE To identify neuroendocrine tumors of the ampulla, as well as their presentation and management. DESIGN A retrospectiv...

INTRODUCTION Whipple's Pancreaticoduodenectomy has increasingly been used as an appropriate resectional procedure for tumors of the periampullary region which are pancreatic, periampullary, ampullary and biliary tumors. Our aim was to study the distribution and histopathologic features of these tumors and to examine local trends of periampullary neoplasms resected with a PD. METHODS A descrip...

INTRODUCTION In 1898, Allesandro Codivilla performed the first pancreaticoduodenectomy; however, it was Kausch who first described the surgical technique in 1912. More than two decades later (1935), Allen O. Whipple performed a twostaged pancreaticoduodenectomy that involved a biliary diversion and gastrojejunostomy followed by resection of the duodenum and head of the pancreas. In 1941, Whippl...

HYPOTHESIS Completion pancreatectomy in patients with pancreatic leakage associated with postoperative peritonitis after pancreaticoduodenectomy is a viable salvage procedure. DESIGN Retrospective analysis from a cohort of consecutive patients admitted between January 1, 1989, and December 31, 1999, for postoperative peritonitis originating from pancreaticojejunostomy leakage. SETTING Terti...

BACKGROUNDS/AIMS To compare surgical results and survival of two groups of patients, age ≥70 vs. age <70, who underwent pancreaticoduodenectomy and to identify the safety of this procedure for elderly patients for the treatment of distal common bile duct (CBD) cancer. METHODS Between January 2003 and December 2009, 55 patients who underwent pancreaticoduodenectomy for the treatment of distal ...

CONTEXT Portal annular pancreas is a rare congenital anomaly resulting from fusion of the pancreatic parenchyma around the portal vein/superior mesenteric vein. It is asymptomatic, but could have serious consequences during pancreatic surgery, if unrecognized. We describe a variant of this anomaly encountered during pancreaticoduodenectomy and propose a new classification. CASE REPORT We repo...

Context Pancreatic exocrine insufficiency is caused by primary diseases such as chronic pancreatitis, cystic fibrosis, and main pancreatic duct occlusion due to a tumor, or it may develop because of pancreatectomy. Steatorrhea or diarrhea, which occurs along with inadequate digestion/absorption of fat, often leads to a diagnosis of pancreatic exocrine insufficiency. Case report An 81-year-old m...

Pancreatic fistula after pancreaticoduodenectomy represents a critical trigger of potentially life-threatening complications and is also associated with markedly prolonged hospitalization. Many arguments have been proposed for the method to anastomosis the pancreatic stump with the gastrointestinal tract, such as invagination vs. duct-to-mucosa, Billroth I (Imanaga) vs. Billroth II (Whipple and...

OBJECTIVES This study investigated the impact of neoadjuvant radiation therapy (XRT) on postoperative outcomes following pancreaticoduodenectomy for pancreatic cancer. METHODS The American College of Surgeons National Quality Improvement Program database was queried for the period 2005-2010 to assess complication rates following pancreaticoduodenectomy for pancreatic cancer. Two groups of pat...