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Main Pancreatic Duct (main + pancreatic_duct)

Distribution by Scientific Domains

Medical Sciences	87%

Selected Abstracts

NEW APPLICATION OF NARROW BAND IMAGING FOR CHOLANGIOPANCREATOSCOPY

DIGESTIVE ENDOSCOPY, Issue 2007
Mitsuhiro Kida
The usefulness of narrow band imaging (NBI), which is based on the principle that the depth of light penetration depends on its wavelength, has been accepted for evaluating malignant or benign lesions in the pharynx, the upper, and lower gastrointestine. The purpose of the present paper was to investigate NBI for diagnosing biliopancreatic disease. Using NBI it has become easy to detect the surface microstructure of biliary mucosa and subjacent vascular network of the bile duct, and inflammatory scarring stenosis is visualized as a whitish scar and multiple inflammatory red spots. However, bile duct cancer was detected as a stenosis with abnormal subjacent vessels and irregular surface. Concerning pancreatic duct, NBI has clearly shown vascular network and spreading of branch-type intraductal papillary mucinous neoplasm to the main pancreatic duct. In contrast, bile juice has been detected as red fluid and bleeding as black red. Therefore, it is important to flush the biliary system before observing with NBI. [source]

WHAT KIND OF BENEFIT DO WE EXPECT FOR PERORAL PANCREATOSCOPY IN THE DIAGNOSIS OF INTRADUCTAL PAPILLARY MUCINOUS TUMOR OF THE PANCREAS?

DIGESTIVE ENDOSCOPY, Issue 2006
Taketo Yamaguchi
Intraductal papillary mucinous tumor (IPMT) of the pancreas is characterized by slow growth and a relatively favorable prognosis, however, invasive cancer originating in an IPMT is associated with a poor prognosis. Although various parameters in imaging modalities have been advocated to differentiate between benign IPMN and malignant ones, it is not easy to obtain definite diagnosis based on these parameters. Peroral pancreatoscopy (POPS) allows a clear and direct visualization of the pancreatic duct, providing useful information regarding tumor nature in IPMT. The authors have studied the usefulness of POPS in the diagnosis of IPMT. Nevertheless, its usefulness is not necessarily widely accepted and the significance of POPS is still controversial. In this review, the authors intended to address the diagnostic value of POPS and to clarify its role in the diagnosis of IPMT. The authors think treatment of IPMT can be improved by introducing POPS because the determination of surgical procedure as well as the area of resection based on the preoperative diagnosis of the involvement of the main pancreatic duct and branch duct is inevitable. [source]

COMPARISON OF THE HEIGHT OF PAPILLARY TUMOR IN INTRADUCTAL PAPILLARY MUCINOUS NEOPLASM OF THE PANCREAS BETWEEN MEASURED PREOPERATIVE IMAGES AND RESECTED MATERIAL

DIGESTIVE ENDOSCOPY, Issue 2006
Kiyohito Tanaka
The height of the mural nodules and papillary tumors in main pancreatic duct or dilated branch duct is the most important factor for diagnosis of intraductal papillary mucinous neoplasm (IPMN). In this study, the authors compared the height of the papillary lesions and mural nodules between the height of resected tissues and the height detected by the preoperative imaging tools (endoscopic ultrasonography [EUS] and intraductal ultrasonography [IDUS]) in 38 patients with IPMN. In 21 out of 23 cases of adenoma, and in cases with the non-invasive cancer, the difference of the height of operative and preoperative analysis measured by EUS and IDUS was within 1,2 mm. EUS and IDUS are useful for diagnosis of degree of malignancy in IPMN. [source]

Epidermoid cyst of the intrapancreatic accessory spleen producing CA19-9

DIGESTIVE ENDOSCOPY, Issue 3 2004
Hiroyuki Watanabe
We report a rare case of an epidermoid cyst in an accessory spleen at the pancreatic tail with producing CA19-9. A 55-year-old female was admitted to our hospital, Cancer Research Institute, Kanazawa University, for close examination of a cystic lesion at the pancreatic tail and a high serum CA19-9-value (176 U/mL). There were almost no abdominal symptoms related to the cystic lesion. A cystic tumor approximately 3 cm in diameter and composed of multilocular cysts without a protruding portion of the inner surface was found at the pancreatic tail by ultrasound sonography, computed tomography, and magnetic resonance imaging. Endoscopic retrograde pancreatography revealed that the main pancreatic duct shifted at the pancreatic tail and there was no communication between the main pancreatic duct and cystic lesion. Based on a preoperative diagnosis of mucinous cystic tumor, distal pancreatectomy with splenectomy was performed. Histological ,ndings suggested an epidermoid cyst (3.5 × 3.0 cm) originating from an intrapancreatic accessory spleen. Immunohistochemical analysis of CA19-9 in the epidermoid cyst showed clear staining of the inner epithelium of the cyst and amorphous or hyalinous cystic contents. The serum CA19-9 value was con,rmed to decline to normal 2 months after resection. Physicians should not forget this disease during differential diagnosis related to pancreatic cystic lesions with elevated levels of serum tumor markers, such as CA19-9 or carcinoembryonic antigen, although this disease is extremely rare. [source]

Total pancreatectomy in six patients with intraductal papillary mucinous tumour of the pancreas: the treatment of choice

HPB, Issue 4 2001
J Bendix Holme
Background Intraductal papillary mucinous tumours (IPMT) were described as a distinct entity in 1982. The extent of surgical resection remains controversial. Methods Six patients with a diffuse dilatation of the main pancreatic duct were treated with total pancreatectomy for cure of IPMT. Results Histological examination showed one IPM adenoma, four IPM non-invasive carcinomas and one IPM invasive carcinoma. In all but one case multifocal extensive intraductal changes were found, affecting either most of the pancreas or the whole organ. All patients survived the operation and remain alive 5,56 months later. Post-pancreatectomy diabetes has been moderately well controlled. Discussion IPMTs represent a subgroup of pancreatic neoplasms with a favourable prognosis, and the resection should aim at removing all dysplastic foci. In cases with diffuse dilatation of the main pancreatic duct, widespread tumour involvement of the duct system can be expected, so total pancreatectomy should be the operation of choice. [source]

Pancreatic acinar cell carcinoma extending into the common bile and main pancreatic ducts

PATHOLOGY INTERNATIONAL, Issue 10 2006
Rin Yamaguchi
Acinar cell carcinoma (ACC) of the pancreas is relatively rare, accounting for only approximately 1% of all exocrine pancreatic tumors. A 69-year-old man was found to have a mass lesion measuring approximately 4 cm in diameter in the pancreatic head on ultrasound, abdominal dynamic CT, and percutaneous transhepatic cholangiography. Magnetic resonance cholangiopancreatography showed defect of the lower common bile duct (CBD) due to obstruction by the tumor cast. Histopathologically, the pancreatic head tumor invaded the main pancreatic duct (MPD) and CBD with extension into the CBD in a form of tumor cast. The tumor cells consisted of a solid proliferation with abundant eosinophilic cytoplasm and round nuclei in an acinar and trabecular fashion. A 55-year-old man with upper abdominal pain and nausea, had a cystic lesion approximately 3 cm in size in the pancreatic tail on CT. Histopathologically, the tumor was encapsulated by fibrous capsule and had extensive central necrosis with solid areas in the tumor periphery, and invaded with extension into the MPD in a form of tumor cast. The tumor cells resembled acinar cells in solid growths. Two resected cases of ACC with unusual tumor extension into the CBD and the MPD, respectively, are reported. [source]

The ontogeny of the alimentary tract of larval pandora, Pagellus erythrinus L.

JOURNAL OF FISH BIOLOGY, Issue 2004
V. Micale
The ontogenesis of the alimentary tract and its associated structures (liver, pancreas, gall bladder) was studied in common pandora Pagellus eythrinus L., a promising species for diversification in Mediterranean aquaculture. Mass production of pandora has been limited so far by high larval and juvenile mortalities, which appear to be related to nutritional deficiencies. The development of the larval digestive system was studied histologically from hatching (0 DAH) until day 50 (50 DAH) in reared specimens, obtained by natural spawning from a broodstock adapted to captivity. At first feeding (3,4 DAH) both the mouth and anus had opened and the digestive tract was differentiated in four portions: buccopharynx, oesophagus, incipient stomach and intestine. The pancreas, liver and gall bladder were also differentiated at this stage. Soon after the commencement of exogenous feeding (5,6 DAH), the anterior intestinal epithelium showed large vacuoles indicating the capacity for absorption of lipids, whereas acidophilic supranuclear inclusions indicating protein absorption were observed in the posterior intestinal epithelium. Both the bile and main pancreatic ducts had opened in the anterior intestine, just after the pyloric sphincter, at this stage. Intestinal coiling was apparent since 4 DAH, while mucosal folding began at 10 DAH. Scattered mucous cells occurred in the oral cavity and the intestine, while they were largely diffused in the oesophagus. Gastric glands and pyloric caeca were firstly observed at 28 DAH and appeared well developed by 41 DAH, indicating the transition from larval to juvenile stage and the acquisition of an adult mode of digestion. [source]