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A Puestow procedure is indicated for the treatment of symptomatic chronic pancreatitis patients with pancreatic ductal obstruction and a dilated main pancreatic duct. The main pancreatic duct needs to be 6mm in diameter in the body of the pancreas for this procedure to be possible.
Gross pathology: Main duct, branch duct, and mixed duct lesions, which determines surgical management. Main duct lesion is the segmental or diffuse dilatation of main pancreatic duct greater than 5 mm without other causes of obstruction. Meanwhile, branch duct lesion is the pancreatic cyst more than 5 mm that communicates with the main duct.
The stone is impacted in the distal common bile duct. A nasobiliary tube has been inserted. Fluoroscopic image showing dilatation of the pancreatic duct during ERCP investigation. Endoscope is visible. Obstructive jaundice – This may be due to several causes Gallstones with dilated bile ducts on ultrasonography
The major duodenal papilla is situated in the second part of the duodenum, 7–10 cm from the pylorus, at the level of the second or third lumbar vertebrae. It is surrounded by the sphincter of Oddi , a circular muscle, and receives a mixture of pancreatic enzymes and bile from the Ampulla of Vater , which drains both the pancreatic duct and ...
Treatment of chronic pancreatitis typically includes pain control and management of exocrine insufficiency. Intractable abdominal pain is the main surgical indication for surgical management of chronic pancreatitis. [12] Removal of the head of the pancreas can relieve pancreatic duct obstruction associated with chronic pancreatitis. [13]
It is usually solitary and found in the body or tail of the pancreas, and may be associated with von Hippel–Lindau syndrome. [2] In contrast to some of the other cyst-forming tumors of the pancreas (such as the intraductal papillary mucinous neoplasm and the pancreatic mucinous cystadenoma), serous cystic neoplasms are almost always entirely ...
Normally, the two ducts will fuse together to form one main pancreatic duct; this occurs in more than 90% of embryos. In approximately 10% of embryos the ventral and dorsal ducts fail to fuse together, resulting in pancreas divisum. In utero, the majority of the pancreas is drained by the dorsal duct which opens up into the minor duodenal papilla.
The ampulla of Vater, hepatopancreatic ampulla or hepatopancreatic duct is the common duct that is usually formed by a union of the common bile duct and the pancreatic duct within the wall of the duodenum. This common duct usually features a dilation ("ampulla").