Pancreas
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Obstructive pancreatic duct stones can cause recurrent attacks of acute pancreatitis and chronic abdominal pain. Use of extracorporeal shock wave lithotripsy (ESWL) for treatment of abdominal pain associated with obstructive pancreatic duct stones has been well documented. However, its effect on prevention of recurrent pancreatitis in this group of patients has not been studied. ⋯ CT - computed tomography, ERCP - endoscopic retrograde cholangiopancreatography, ESWL - extracorporeal shock wave lithotripsy.
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In branch duct intraductal papillary mucinous neoplasm (IPMN) of the pancreas, the importance of the cyst size to predict malignancy is still controversial. Our aim was to elucidate the malignant potential of branch duct IPMN without mural nodules (flat branch duct IPMN). ⋯ We conclude that the size criteria (> or =30 mm) to predict malignancy proposed in the international consensus guidelines is appropriate and resection or meticulous follow-up using cytological examination and MPD dilatation is needed in patients with flat branch duct IPMNs.
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Minimally invasive surgery is beneficial for complex operations; robotics may improve performance in these procedures; however, robotic pancreaticoduodenectomy (PD) has been plagued by long operative times. We describe a small series (n = 5) of patients who underwent a hybrid PD for treatment of obstructive jaundice and pancreatic mass. ⋯ Complex procedures such as PD can be accomplished with minimally invasive surgical techniques using robotic instrumentation.