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Postoperative Pancreas
Siva P. Raman, MD
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KEY FACTS

  • Imaging

    • Clinical Issues

      IMAGING

      • General Features

        • CT Findings

          • Imaging Recommendations

            DIFFERENTIAL DIAGNOSIS

              PATHOLOGY

              • Staging, Grading, & Classification

                • Gross Pathologic & Surgical Features

                  CLINICAL ISSUES

                  • Presentation

                    • Natural History & Prognosis

                      • Treatment

                        DIAGNOSTIC CHECKLIST

                        • Consider

                          Selected References

                          1. Raman SP et al: CT after pancreaticoduodenectomy: spectrum of normal findings and complications. AJR Am J Roentgenol. 201(1):2-13, 2013
                          2. Hwang HK et al: Comparison of efficacy of enucleation and pancreaticoduodenectomy for small (<3 cm) branch duct type intraductal papillary mucinous neoplasm located at the head of pancreas and the uncinate process. Yonsei Med J. 53(1):106-10, 2012
                          3. Kunstman JW et al: Comprehensive analysis of variables affecting delayed gastric emptying following pancreaticoduodenectomy. J Gastrointest Surg. 16(7):1354-61, 2012
                          4. Pecorelli N et al: Effect of surgeon volume on outcome following pancreaticoduodenectomy in a high-volume hospital. J Gastrointest Surg. 16(3):518-23, 2012
                          5. Yamauchi FI et al: Multidetector CT evaluation of the postoperative pancreas. Radiographics. 32(3):743-64, 2012
                          6. Cronin CG et al: Interventional radiology in the management of abdominal collections after distal pancreatectomy: a retrospective review. AJR Am J Roentgenol. 197(1):241-6, 2011
                          7. Puppala S et al: Hemorrhagic complications after Whipple surgery: imaging and radiologic intervention. AJR Am J Roentgenol. 196(1):192-7, 2011
                          8. Ren S et al: Complications after pancreaticoduodenectomy for pancreatic cancer: a retrospective study. Int Surg. 96(3):220-7, 2011
                          9. Roulin D et al: Systematic review of delayed postoperative hemorrhage after pancreatic resection. J Gastrointest Surg. 15(6):1055-62, 2011
                          10. Sakamoto Y et al: Analysis of risk factors for delayed gastric emptying (DGE) after 387 pancreaticoduodenectomies with usage of 70 stapled reconstructions. J Gastrointest Surg. 15(10):1789-97, 2011
                          11. Wolfgang CL et al: Pancreatic surgery for the radiologist, 2011: an illustrated review of classic and newer surgical techniques for pancreatic tumor resection. AJR Am J Roentgenol. 197(6):1343-50, 2011
                          12. Zureikat AH et al: Can laparoscopic pancreaticoduodenectomy be safely implemented? J Gastrointest Surg. 15(7):1151-7, 2011
                          13. Kawai M et al: Analysis of clinical trials evaluating complications after pancreaticoduodenectomy: a new era of pancreatic surgery. Surg Today. 40(11):1011-7, 2010
                          14. Smyrniotis V et al: Does internal stenting of the pancreaticojejunostomy improve outcomes after pancreatoduodenectomy? A prospective study. Langenbecks Arch Surg. 395(3):195-200, 2010
                          15. Berger AC et al: Does type of pancreaticojejunostomy after pancreaticoduodenectomy decrease rate of pancreatic fistula? A randomized, prospective, dual-institution trial. J Am Coll Surg. 208(5):738-47; discussion 747-9, 2009
                          16. Fuks D et al: Life-threatening postoperative pancreatic fistula (grade C) after pancreaticoduodenectomy: incidence, prognosis, and risk factors. Am J Surg. 197(6):702-9, 2009
                          17. Iqbal N et al: A comparison of pancreaticoduodenectomy with extended pancreaticoduodenectomy: a meta-analysis of 1909 patients. Eur J Surg Oncol. 35(1):79-86, 2009
                          18. House MG et al: Preoperative predictors for complications after pancreaticoduodenectomy: impact of BMI and body fat distribution. J Gastrointest Surg. 12(2):270-8, 2008
                          19. Lytras D et al: Therapeutic strategies for the management of delayed gastric emptying after pancreatic resection. Langenbecks Arch Surg. 392(1):1-12, 2007
                          20. Nakao A et al: Pancreatic head resection with segmental duodenectomy: safety and long-term results. Ann Surg. 246(6):923-8; discussion 929-31, 2007
                          21. Topal B et al: Determinants of complications in pancreaticoduodenectomy. Eur J Surg Oncol. 33(4):488-92, 2007
                          22. DeOliveira ML et al: Assessment of complications after pancreatic surgery: A novel grading system applied to 633 patients undergoing pancreaticoduodenectomy. Ann Surg. 244(6):931-7; discussion 937-9, 2006
                          23. Satoi S et al: Less morbidity after pancreaticoduodenectomy of patients with pancreatic cancer. Pancreas. 33(1):45-52, 2006
                          24. Yang YM et al: Risk factors of pancreatic leakage after pancreaticoduodenectomy. World J Gastroenterol. 11(16):2456-61, 2005
                          25. Kimura F et al: Sepsis delays gastric emptying following pylorus-preserving pancreaticoduodenectomy. Hepatogastroenterology. 49(44):585-8, 2002
                          Related Anatomy
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                          Related Differential Diagnoses
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                          References
                          Tables

                          Tables

                          KEY FACTS

                          • Imaging

                            • Clinical Issues

                              IMAGING

                              • General Features

                                • CT Findings

                                  • Imaging Recommendations

                                    DIFFERENTIAL DIAGNOSIS

                                      PATHOLOGY

                                      • Staging, Grading, & Classification

                                        • Gross Pathologic & Surgical Features

                                          CLINICAL ISSUES

                                          • Presentation

                                            • Natural History & Prognosis

                                              • Treatment

                                                DIAGNOSTIC CHECKLIST

                                                • Consider

                                                  Selected References

                                                  1. Raman SP et al: CT after pancreaticoduodenectomy: spectrum of normal findings and complications. AJR Am J Roentgenol. 201(1):2-13, 2013
                                                  2. Hwang HK et al: Comparison of efficacy of enucleation and pancreaticoduodenectomy for small (<3 cm) branch duct type intraductal papillary mucinous neoplasm located at the head of pancreas and the uncinate process. Yonsei Med J. 53(1):106-10, 2012
                                                  3. Kunstman JW et al: Comprehensive analysis of variables affecting delayed gastric emptying following pancreaticoduodenectomy. J Gastrointest Surg. 16(7):1354-61, 2012
                                                  4. Pecorelli N et al: Effect of surgeon volume on outcome following pancreaticoduodenectomy in a high-volume hospital. J Gastrointest Surg. 16(3):518-23, 2012
                                                  5. Yamauchi FI et al: Multidetector CT evaluation of the postoperative pancreas. Radiographics. 32(3):743-64, 2012
                                                  6. Cronin CG et al: Interventional radiology in the management of abdominal collections after distal pancreatectomy: a retrospective review. AJR Am J Roentgenol. 197(1):241-6, 2011
                                                  7. Puppala S et al: Hemorrhagic complications after Whipple surgery: imaging and radiologic intervention. AJR Am J Roentgenol. 196(1):192-7, 2011
                                                  8. Ren S et al: Complications after pancreaticoduodenectomy for pancreatic cancer: a retrospective study. Int Surg. 96(3):220-7, 2011
                                                  9. Roulin D et al: Systematic review of delayed postoperative hemorrhage after pancreatic resection. J Gastrointest Surg. 15(6):1055-62, 2011
                                                  10. Sakamoto Y et al: Analysis of risk factors for delayed gastric emptying (DGE) after 387 pancreaticoduodenectomies with usage of 70 stapled reconstructions. J Gastrointest Surg. 15(10):1789-97, 2011
                                                  11. Wolfgang CL et al: Pancreatic surgery for the radiologist, 2011: an illustrated review of classic and newer surgical techniques for pancreatic tumor resection. AJR Am J Roentgenol. 197(6):1343-50, 2011
                                                  12. Zureikat AH et al: Can laparoscopic pancreaticoduodenectomy be safely implemented? J Gastrointest Surg. 15(7):1151-7, 2011
                                                  13. Kawai M et al: Analysis of clinical trials evaluating complications after pancreaticoduodenectomy: a new era of pancreatic surgery. Surg Today. 40(11):1011-7, 2010
                                                  14. Smyrniotis V et al: Does internal stenting of the pancreaticojejunostomy improve outcomes after pancreatoduodenectomy? A prospective study. Langenbecks Arch Surg. 395(3):195-200, 2010
                                                  15. Berger AC et al: Does type of pancreaticojejunostomy after pancreaticoduodenectomy decrease rate of pancreatic fistula? A randomized, prospective, dual-institution trial. J Am Coll Surg. 208(5):738-47; discussion 747-9, 2009
                                                  16. Fuks D et al: Life-threatening postoperative pancreatic fistula (grade C) after pancreaticoduodenectomy: incidence, prognosis, and risk factors. Am J Surg. 197(6):702-9, 2009
                                                  17. Iqbal N et al: A comparison of pancreaticoduodenectomy with extended pancreaticoduodenectomy: a meta-analysis of 1909 patients. Eur J Surg Oncol. 35(1):79-86, 2009
                                                  18. House MG et al: Preoperative predictors for complications after pancreaticoduodenectomy: impact of BMI and body fat distribution. J Gastrointest Surg. 12(2):270-8, 2008
                                                  19. Lytras D et al: Therapeutic strategies for the management of delayed gastric emptying after pancreatic resection. Langenbecks Arch Surg. 392(1):1-12, 2007
                                                  20. Nakao A et al: Pancreatic head resection with segmental duodenectomy: safety and long-term results. Ann Surg. 246(6):923-8; discussion 929-31, 2007
                                                  21. Topal B et al: Determinants of complications in pancreaticoduodenectomy. Eur J Surg Oncol. 33(4):488-92, 2007
                                                  22. DeOliveira ML et al: Assessment of complications after pancreatic surgery: A novel grading system applied to 633 patients undergoing pancreaticoduodenectomy. Ann Surg. 244(6):931-7; discussion 937-9, 2006
                                                  23. Satoi S et al: Less morbidity after pancreaticoduodenectomy of patients with pancreatic cancer. Pancreas. 33(1):45-52, 2006
                                                  24. Yang YM et al: Risk factors of pancreatic leakage after pancreaticoduodenectomy. World J Gastroenterol. 11(16):2456-61, 2005
                                                  25. Kimura F et al: Sepsis delays gastric emptying following pylorus-preserving pancreaticoduodenectomy. Hepatogastroenterology. 49(44):585-8, 2002