The authors report the complex case of a 51 year-old man admitted to his local hospital for gallbladder and common bile duct lithiasis, 1 year before admission to our hospital. There, he was treated by cholecystectomy and transduodenal biliary sphincteroplasty. He was readmitted after 3 months because of a painful episode and was discharged with the diagnosis of "relapsing acute pancreatitis in chronic pancreatitis." At our hospital, he underwent laparotomy and revision of the previous transduodenal biliary sphincteroplasty. Pancreatic sphincteroplasty and septectomy were also performed. The night after surgery, the patient suffered from acute post-operative pancreatitis complicated by severe hemorrhage due to erosion of the superior pancreaticoduodenal arteries, treated with gastroduodenal artery embolization by tungsten coils. Three months later, the patient suffered from another acute episode. An endoscopic retrograde colangio pancreatography (ERCP) showed the complete patency of the sphincteroplasties but clearly identified the persistence of a severe cephalic stricture. Therefore, the patient was readmitted to our hospital and underwent another laparotomy. A pylorus-preserving pancreaticoduodenectomy (PPPD) was performed. The post-operative course was uneventful and at 14 months follow-up the patient was in good health. The discussion focuses on the surgical treatment of chronic pancreatitis with cephalic Wirsung duct stenosis, stressing the increasing role of PPPD as a first-choice option.

Lessons learned from a complicated case of cephalic obstructive chronic pancreatitis / Proposito, Delia; M., Catarci; Roberto, Santoro; Fabrizia, Scardamaglia; B., Mancini; Gallina, Stefano; Uccini, Stefania; G., Mulieri; Carboni, Manlio. - In: HEPATO-GASTROENTEROLOGY. - ISSN 0172-6390. - STAMPA. - 45:24(1998), pp. 2404-2409.

Lessons learned from a complicated case of cephalic obstructive chronic pancreatitis

PROPOSITO, Delia;GALLINA, STEFANO;UCCINI, Stefania;CARBONI, Manlio
1998

Abstract

The authors report the complex case of a 51 year-old man admitted to his local hospital for gallbladder and common bile duct lithiasis, 1 year before admission to our hospital. There, he was treated by cholecystectomy and transduodenal biliary sphincteroplasty. He was readmitted after 3 months because of a painful episode and was discharged with the diagnosis of "relapsing acute pancreatitis in chronic pancreatitis." At our hospital, he underwent laparotomy and revision of the previous transduodenal biliary sphincteroplasty. Pancreatic sphincteroplasty and septectomy were also performed. The night after surgery, the patient suffered from acute post-operative pancreatitis complicated by severe hemorrhage due to erosion of the superior pancreaticoduodenal arteries, treated with gastroduodenal artery embolization by tungsten coils. Three months later, the patient suffered from another acute episode. An endoscopic retrograde colangio pancreatography (ERCP) showed the complete patency of the sphincteroplasties but clearly identified the persistence of a severe cephalic stricture. Therefore, the patient was readmitted to our hospital and underwent another laparotomy. A pylorus-preserving pancreaticoduodenectomy (PPPD) was performed. The post-operative course was uneventful and at 14 months follow-up the patient was in good health. The discussion focuses on the surgical treatment of chronic pancreatitis with cephalic Wirsung duct stenosis, stressing the increasing role of PPPD as a first-choice option.
1998
chronic pancreatitis; gastrointestinal hemorrhage; pancreatic sphincteroplasty; pancreaticoduodenectamy; pancreaticoduodenectomy
01 Pubblicazione su rivista::01a Articolo in rivista
Lessons learned from a complicated case of cephalic obstructive chronic pancreatitis / Proposito, Delia; M., Catarci; Roberto, Santoro; Fabrizia, Scardamaglia; B., Mancini; Gallina, Stefano; Uccini, Stefania; G., Mulieri; Carboni, Manlio. - In: HEPATO-GASTROENTEROLOGY. - ISSN 0172-6390. - STAMPA. - 45:24(1998), pp. 2404-2409.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/126017
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