Hepato Gastroenterol
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There is a diversity of mucin-producing tumors of the pancreas, including benign adenoma, malignant intraductal papillary carcinoma and invasive papillary carcinoma. However, there has been little discussion of appropriate techniques for surgically treating these tumors. ⋯ The prognosis for surgically resectable mucin-producing pancreatic tumors is better than that for invasive pancreatic duct carcinoma. When treating mucin-producing pancreatic tumors surgically, techniques which allow preservation of pancreatic and gastroenteric functions should be selected when possible. These techniques include PPPD, DPPHR and pancreatic segmentectomy. A total pancreatectomy should only be selected in cases where cancer has invaded the entire pancreas (especially when cancer has invaded the duct within the pancreatic head, through the tail). It may also be used when residual cancer cells have been detected by intra-operative pathological examination at the distal stump of the pancreas. During surgery with any technique, leakage of pancreatic duct mucus into the operating field must be avoided.
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Hepato Gastroenterol · Nov 1998
Case ReportsSuccessful conservative treatment for esophageal perforation by a fish bone associated with mediastinitis.
A 74 year-old man presenting with esophageal perforation associated with mediastinitis due to the swallowing of a fish bone is reported herein. Conservative treatment, including starvation therapy and the injection of antibiotic drugs, proved to be successful for this patient. Although the optimal treatment for esophageal perforation remains controversial, it is important to choose the appropriate strategies when treating cases of esophageal perforation with mediastinitis.