Search PubMed⌕ Search

PubMed · 2531449

[Juxtapapillary ulcer].

Abstract

The paper analysed the technical possibilities for the treatment of juxtapapillary ulcer exemplified by the clinical experience of 62 cases of recognized juxtapapillary ulcer. The authors insist on the technique of the duodenum dissection, on the way of passing the suture threads at the level of the papilla and on the importance of a correct drainage.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

M Stăncescu, M Ionescu. [Juxtapapillary ulcer].. https://pubmed.ncbi.nlm.nih.gov/2531449/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Analysis of the quality and efficiency in learning laparoscopic skills.

OBJECTIVES: This study demonstrates the application of time-action analysis to the evaluation of task performance of diagnostic laparoscopy with laparoscopic ultrasonography. METHODS: The first 25 diagnostic laparoscopies with laparoscopic ultrasonography performed by a surgical resident were analyzed and compared with the outcomes of these procedures performed by an experienced surgeon. The time, actions, and correctness of task performance were evaluated. Furthermore, outcome correctness and postoperative complications were assessed. RESULTS: No postoperative complications occurred. The resident made one wrong diagnosis, for which the cause was detected by peroperative analysis. Additionally, 1% of the subtasks were performed only partially, 4% not at all, and 2% using the wrong technique. The efficiency for most diagnostic tasks remained significantly lower than that of the experienced surgeon (p < 0.001). CONCLUSIONS: Time-action analysis can be used to provide detailed insight into the quality and efficiency of learning surgical skills. It enables objective measurement of correctness in task performance as well as time and action efficiency.

Ampulla of Vater↗

Carcinogenesis of cancer of the papilla and ampulla: pathophysiological facts and molecular biological mechanisms.

BACKGROUND: Ampullary cancer has one of the highest resectability rates and best prognoses among neoplasms arising in the periampullary region. DISCUSSION: Early diagnosis due to early symptoms can partially explain the better prognosis as compared to other cancers of the periampullary region, but biologic factors should also be taken in account. In the past few years, the molecular mechanisms underlying this disease have been investigated and alterations of genes that regulate different cell functions have been described. Mutations of K-ras and of the tumor suppressor genes APC, p16 and p53 indicate a major disturbance in cell cycle regulation. CONCLUSIONS: If the molecular profile of ampullary cancer is examined in terms of rate and type of molecular changes, it seems to be more similar to intestinal than to pancreatic cancer. Furthermore, the fact that many ampullary carcinomas arise from adenomas and the frequent finding of ampullary tumors in patients affected by polyposis syndromes also suggest that ampullary and colon cancers share common molecular mechanisms of carcinogenesis.

Ampulla of Vater↗

Is a preoperative multidiagnostic approach to predict surgical resectability of periampullary tumors still effective?

BACKGROUND: Multimodality staging is recommended in patients with periampullary tumors to optimize preoperative determination of resectability. We investigated the potency of currently used diagnostic procedures in order to determine resectability. METHODS: Ninety-five consecutive patients with periampullary tumors prehospitally staged resectable underwent preoperative diagnostic tests: helical-computed tomography (CT) with maximum intensity projection of arterial vessels (MIP), magnetic resonance imaging (MRI), magnetic resonance cholangiopancreaticography (MRCP), endoscopic ultrasonography (EUS), endoscopic retrograde cholangiopancreaticography (ERCP), digital subtraction angiography (DSA), and positron emission tomography (PET). Diagnoses were verified by surgery and histopathology. RESULTS: In 45 patients with benign and 50 patients with malignant periampullary tumors sensitivity for tumor diagnosis was 89% to 96% in CT, MRI, EUS, and PET. Small tumors were best diagnosed by EUS (100%). Diagnosis of malignancy was made with 85% (EUS), 83% (CT), 82% (PET), and 72% (MRI) accuracy. Arterial vessel infiltration was best predicted by CT/MIP with an accuracy of 85%. For venous vessel infiltration MRI reached 85% accuracy. Accuracy rates for local nonresectability were 93% (EUS), 92% (MRI), and 90% (CT). Two and 4 of 8 patients with distant metastases were identified by CT and PET, respectively. The correct diagnosis of malignancy and determination of resectability was made by CT in 71% and by MRI in 70%. Biliary stenting reduced accuracy of CT diagnosis of malignancy from 88% to 73%. CONCLUSIONS: CT obtained before stenting was the single most useful test, providing correct diagnosis in 88% and resectability in 71% of patients. If no tumor is depicted in CT, EUS should be added. Uncertain venous vessel infiltration can be verified by MRI or EUS. Angiography should no longer be a routine diagnostic procedure. Equivocal tumors or possible metastasis may be further examined with PET.

Ampulla of Vater↗