Type:
Educational Exhibit
Keywords:
Not applicable, Cancer, Surgery, CT, Pancreas, Abdominal Viscera
Authors:
A. I. Neagu, C.-I. Betianu; Bucharest/RO
DOI:
10.26044/ecr2020/C-07283
Background
Pancreaticoduodenectomy is a procedure performed most commonly as the treatment of choice in pancreatic adenocarcinoma, which represents the only curative option for this condition, despite all the advances in medical and radiation oncology [1] . However, with the recent developments of both surgical techniques and chemoradiation regimens, patients with limited vascular involvement, which would have previously been rendered inoperable, are now eligible for surgery[2].
Other indications include various periampullary cancers (affecting the papilla of Vater, distal bile duct or duodenum), chronic pancreatitis, neuroendocrine tumors, intraductal papillary mucinous neoplasms, cystadenomas/cystadenocarcinomas, ampullary/duodenal adenomas and less frequently pancreatic metastases and gastrointestinal stromal tumours [3].
Initially considered a very complex and high-risk procedure, the pancreaticoduodenectomy reached mortality rates as high as 25%, which have decreased significantly over the years, nowadays having a mortality of 1%, with a substantial drop in operative time, blood loss and length of hospitalization [3]. A contribution to the improvement of the perioperative mortality rates can be attributed to computer tomography, which represents the investigation of choice for imaging the postsurgical pancreas, allowing the early identification of the possible complications that might arise following the Whipple procedure [2].