Sevens cases of pancrea duodenal emergency cutting showed: the combining of the injuries of pancreas and duodenum in a clinical image of multiplex injuries. In these conditions, blood Amylaza level, urine or abdomen fluid and the CT scanning gave diagnostic values in pancrea damage and the combining damage of compact diathesis. Pancrea duodenal cutting must be indicated when the vascularization into duodenum and pacrea head could not be controlled; blood injury and loss of pulse or irreversible injury in the area of Vater ampulla; IV grade of pancrea duodenal injury as well as in the favorable conditions of anesthesia resuscitation with qualified surgeons.
Surgery ; Emergencies ; Pancreas ; Duodenum

From 1980 to 2003 at Binh Dan Hospital had performed 120 Whipple procedures that 37 were classical and 83 modified. As mean age, there was 43 and 45. About pathologies, there were 23 cases of pancreatic head, 55 cases of billiary duct, 5 cases of duodenum and 1 advanced case of gall bladder. In comparison of the classical Whipple group and the modified one, the mean operating time was 4 hrs 10 mns and 2 hrs 40 mns, the mean blood loss was 1000ml and 300ml, the early complications and hospital death were 19% - 5.4% and 12.25% - 4.8%, the hospital stays in post operation were 17 and 13, the late complications and the survival rate were 14.2% - 1.26% and 33% - 32%
Therapeutics ; epidemiology ; Gallbladder ; surgery ; duodenum

Study on 4 cases of malignant tumor of Vater’s ampulla operated at Viet-Duc Hospital and 1 case treated at University of Medicine and Pharmacy at Ho Chi Minh City between August 2003 and December 2004. Results: clinical sign is biliary obstruction jaundice. Gastroduodenoscopy with flexible tube found that papilla of Vater with the diameter lower than 3cm (histological finding: carcinomas), without metastasis to adjacent duodenum. Tumor invasion into head of pancreas and the lower of choledochous duct was determined by pancreatic and liver ultrasound, CT scanner or MRI examinations, in combination with intraoperative balance, immediate biopsy of lymph nodes in group 14 and group 8, sections of bile duct, pancreatic duct and duodenum in order to ensure the elimination of surgery. Initial outcomes showed that there wasn’t post-operative complication or death.
Ampulla of Vater ; Duodenum ; Therapeutics ; Surgery

Humans ; Pancreaticoduodenectomy ; Pancreatectomy ; Pancreas/surgery* ; Duodenum/surgery* ; Pancreatic Neoplasms/surgery*

Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury to the pancreatic-duodenal-biliary complex occurs simultaneously. Even the patients receive surgeries in time, multiple postoperative complications and high mortality are common. To know and manage duodenal trauma better, we searched the recent related literature in PubMed by the keywords of duodenal trauma, therapy, diagnosis and abdomen. It shows that because the diagnosis and management are complicated and the mortality is high, duodenal trauma should be treated in time and tactfully. And application of new technology can help improve the management. In this review, we discussed the incidence, diagnosis, management, and complications as well as mortality of duodenal trauma.
Duodenum ; injuries ; surgery ; Humans ; Incidence ; Postoperative Complications ; epidemiology

Cholangiopancreatography, Endoscopic Retrograde ; Duodenum ; surgery ; Humans ; Retrospective Studies

Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases and public health problems. Roux-en-Y gastric bypass (RYGB) can rapidly, effectively and sustainably improve glycemic control in morbidly obese patients with T2DM. However, the mechanisms of glycemic control after RYGB are still unclear now. Duodenal-jejunal bypass (DJB) is an improved RYGB sparing intact stomach, which is mainly used to investigate the mechanisms of RYGB to treat T2DM. DJB has also been used to treat non-obese T2DM patients. In the present article, we review the results and mechanisms of DJB to treat T2DM on the basis of the previous studies to further elucidate the mechanisms of RYGB in the management of T2DM.
Diabetes Mellitus, Type 2 ; surgery ; Duodenum ; surgery ; Gastric Bypass ; Humans ; Jejunum ; surgery

OBJECTIVETo compare the safety and effectiveness of DPPHR with PPPD/PD for treating chronic pancreatitis with an inflammatory mass in the head of pancreas.

METHODSThe relative data bases such as Medline, EMBase, Biosis, COCHRANE Library, Science Citation Index, SinoMed, Chinese Journal Full-text Database, Wangfang, CNKI were searched systematically, researchers selected randomized controlled trials (RCT) and prospective clinical controlled trials (CCT) . The assessment of the bias risk of the included trials was according to the assessing tools suggested by Cochrane Handbook 5.1. The Review Manage 5.2 was used to perform the statistical analysis.

RESULTSIn total, 5 RCTs and 2 CCTs were included, 381 patients involved. Comparing with PPPD/PD procedure, DPPHR has no significant difference in terms of the mortality of perioperative period (RD = 0.01, P = 0.51), the incidence of bleeding (RD = -0.01, P = 0.72), pancreatic fistula(RD = -0.01, P = 0.59) and delayed gastric emptying (RD = -0.15, P = 0.10), the ration of complete pain relief after operation (RR = 1.06, P = 0.32) and the score of global quality of life (WMD = 10.31, P = 0.19).While DPPHR had significant superiorities in terms of the total morbidity of perioperative period (RR = 0.60, P = 0.008), the duration of the operations(WMD = -71.60, P = 0.03), the postoperative hospitalization duration(WMD = -3.95, P < 0.01), weight gain(WMD = 3.68, P < 0.01), occupational rehabilitation after the operations (RR = 1.38, P = 0.008).

CONCLUSIONSIn terms of reducing the morbidity of perioperative period, shortening the duration of the operations and the postoperative hospitalization duration, weight gain, occupational rehabilitation after the operations, the DPPHR is more favorable for improving patients' life qualities comparing with PPPD/PD.

Duodenum ; surgery ; Humans ; Pancreas ; surgery ; Pancreatectomy ; methods ; Pancreaticoduodenectomy ; methods ; Pancreatitis, Chronic ; surgery ; Prospective Studies ; Quality of Life

Adolescent ; Bezoars ; surgery ; Duodenum ; surgery ; Female ; Hair ; Humans ; Stomach ; pathology ; Treatment Outcome ; Trichotillomania ; diagnosis ; surgery

BACKGROUNDSurgery is regarded as the most effective treatment to relieve pain and reduce complications in chronic pancreatitis (CP). Two major strategies exist: duodenum-preserving pancreatic head resection (DPPHR) and pancreatoduodenectomy (PD). Many studies suggest that DPPHR offers advantages during surgery and in the short-term; however, the long-term effects have not been thoroughly investigated. We analyzed the long-term outcomes of DPPHR and PD, over follow-up times of at least 1 year, to determine the optimal surgical treatment for CP.

METHODSWe systemically reviewed all CP surgical treatment reports, and only included randomized controlled trials (RCT) comparing DPPHR and PD, excluding unqualified studies using several pre-specified criteria. When multiple publications of a single trial were found, the most comprehensive current data were selected. Characteristics of the study populations and long-term postoperative outcome parameters were collected. The quality of the studies and data was analyzed using RevMan 4.2 software.

RESULTSFive trials were qualified for meta-analysis, with 261 participants in total (114 in the DPPHR group and 147 in the PD group). There were no significant differences in the age, gender, or indications for surgery of each group. At the mean of 5.7-year (1 - 14 years) follow-up examination, DPPHR and PD resulted in equally effective pain relief, exocrine and endocrine function, and similar mortality rates (P > 0.05); however, DPPHR patients had improved global quality of life and weight gain, and reduced diarrhea and fatigue (P < 0.05).

CONCLUSIONDPPHR and PD result in equal pain relief, mortality, and pancreatic function; however, DPPHR provides superior long-term outcomes.

Duodenum ; surgery ; Humans ; Pancreatectomy ; methods ; Pancreaticoduodenectomy ; methods ; Pancreatitis, Chronic ; psychology ; surgery ; Quality of Life ; Time Factors