PubMed · 8114232
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P R Caropreso. 1994-03-16. The learning curve.. https://doi.org/10.1001/jama.271.11.824a
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Ectopic pancreas is a rare entity but the second most prevalent pancreatic anomaly. Heterotopic pancreas is defined as the presence of pancreatic tissue without any anatomic or vascular continuity with the main body of the pancreas. Its aetiology is not clearly established. In 1916, Poppi published for the first time evidence of heterotopic pancreas in the gallbladder. A review of the literature up to the present showed only 28 more cases worldwide of ectopic pancreas in the gallbladder. Aberrant pancreas is incidentally discovered in 2% of autopsies and has been estimated to occur once in every 500 upper abdominal explorations. Ninety per cent of ectopic pancreas is found in the stomach, duodenum, and jejunum. Mostly it is asymptomatic and benign. For this reason, therapy is indicated only in patients with symptoms such as pyloric obstruction, bleeding, and malignant transformation. Surgical resection or endoscopic mucosal resection as a newer method are recommended.
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INTRODUCTION: Over 500 years ago, Vasco de Gama navigated from west to east, from Lisbon in Portugal to Calicut in India, in an epic voyage that lasted over 1 year (Fig. 1). This voyage was perhaps the greatest historic and, certainly, the greatest navigational achievement of the last millennium. For better or for worse, it catalysed a series of events that forever changed not only the history, but also the geography of the world. DISCUSSION: In our plans to navigate endoscopic surgery into the next decade in developing countries, we too should endeavour to change both the history and the geography of surgery. This talk traces a journey over 34 years of effort to spread laparoscopic surgery into developing countries.