Anastomotic Reconstruction and External Drainage of Wirsung's Duct as Treatment for Pancreaticojejunal Stenosis Following Pancreaticoduodenectomy

Publication date: Available online 3 December 2018Source: Cirugía Española (English Edition)Author(s): Iago Justo Alonso, Alberto Marcacuzco Quinto, Oscar Caso Maestro, Carlos Jiménez-RomeroAbstractStenosis of the pancreaticodigestive anastomosis (pancreaticogastrostomy and pancreaticojejunostomy) is a very rare complication that usually develops several years after pancreaticoduodenectomy (PD). Only a few cases have been previously reported. We have reviewed the literature and present 2 more cases of pancreaticojejunostomy stenosis that started with episodes of recurrent acute pancreatitis 6 years and 1 year after PD, respectively. Diagnosis was based on symptoms of pancreatitis (12–15 episodes between 5 and 20 months after PD) and CT and MRI scans. Both patients were treated by resection of the pancreaticojejunostomy stenosis, including a 1-cm slice of pancreatic parenchyma in contact with the jejunum, followed by a new well-vascularized two-layer end-to-side PJ with external drainage of the Wirsung duct. Catheter drainage was exteriorized through a jejunal limb using the Witzel technique. Postsurgical course was uneventful in both cases, and after a follow-up period of 3 and 2.5 years, respectively, the patients remain asymptomatic but with endocrine and exocrine insufficiency. Resection of the PJ and construction of a new PJ with external stent drainage of the Wirsung duct is our preferred surgical option in the rare cases of PJ stenosis after a...
Source: Cirugia Espanola - Category: Surgery Source Type: research

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Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
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Source: Clinica Chimica Acta - Category: Laboratory Medicine Source Type: research
CONCLUSIONS: Our HRM assays detected the presence of functional gene variants that were confirmed with Sanger and NGS sequencing. The presence of multiple functional variant alleles was associated with differences in the clinical profile. Therefore, these assays represent a reliable, cost-effective tool that can be used to complement the NGS approach for gene scanning. PMID: 31669931 [PubMed - as supplied by publisher]
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Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
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Source: Korean J Gastroenter... - Category: Gastroenterology Authors: Tags: Korean J Gastroenterol Source Type: research
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Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
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Source: Neurology India - Category: Neurology Authors: Source Type: research
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Source: Journal of Nippon Medical School - Category: Universities & Medical Training Authors: Tags: J Nippon Med Sch Source Type: research
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