Pancreaticoduodenectomy (PD) has become increasingly acceptable as a safe and appropriate surgical technique for managing malignant or benign diseases of the head of the pancreas and periampullary
Other causes include strictures of the common bile duct, biliary atresia, and cholangiocarcinoma, ampullary and periampullary
carcinoma and carcinoma gall bladder2.
Any factor that interrupts normal bile flow predisposes to infection and subsequently to brown pigment stone formation as is observed with biliary strictures, periampullary
diverticulum and Caroli syndrome.
The patients' questionnaire included history of hepatic or biliary operations, hepatotoxic drug use, chronic alcohol use, hepatitis B or C carrier status, and suspicion of periampullary
The Whipple procedure and periampullary
duodenojejunostomy with gastrojejunostomy have been described for DN (2,3).
07 (7-87) Sex, M/F, n (%) 33/20 (62/38) Site of obstruction, n (%) Gastroduodenal 18 (34) Duodenal 27 (51) Gastrojejunal anastomosis 6 (11) Duodenojejunal 1 (2) Afferent loop 1 (2) Cause of obstruction, n (%) Gastric cancer 20 (38) Pancreatic cancer 19 (36) Cholangiocarcinoma 4 (7) Duodenal cancer 3 (6) Periampullary
tumor 1 (2) Metastasis 5 (9) External compression (neuroblastoma) 1 (2) SD, standard deviation; F, female; M, male.
Abbreviation: PC: Pancreatic carcinoma; BDC: bile duct carcinoma; GC: gallbladder carcinoma; PAC: periampullary
carcinoma; EBL: estimated blood loss; MAP: mean arterial blood pressure; HR: heart rate; ALT: alanine transaminase; PT: Prothrombin Time.
Results of pancreaticoduodenectomy in patients with periampullary
adenocarcinoma: Perineural growth more important prognostic factor than tumor localization.
Molecular analysis of PIK3CA, BRAF, and RAS oncogenes in periampullary
Factors known to increase the risk for developing cholangitis in patients with biliary calculi include: advanced age, neurologic disease, and periampullary
diverticula are rare in patients below 40 years .
MRCP was performed in all cases and correctly identified level and cause of obstruction in all cases (100%), including choledocholithiasis, choledochal cysts, periampullary
and hilar mass, and CBD stricture.