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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

                          • Image Interpretation Pearls

                            Selected References

                            1. Appanraj P et al: CT reporting of relevant vascular variations and its implication in pancreatoduodenectomy. Abdom Radiol (NY). ePub, 2021
                            2. Chincarini M et al: Major pancreatic resections: normal postoperative findings and complications. Insights Imaging. 9(2):173-87, 2018
                            3. Raman SP et al: CT after pancreaticoduodenectomy: spectrum of normal findings and complications. AJR Am J Roentgenol. 201(1):2-13, 2013
                            4. 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
                            5. Kunstman JW et al: Comprehensive analysis of variables affecting delayed gastric emptying following pancreaticoduodenectomy. J Gastrointest Surg. 16(7):1354-61, 2012
                            6. 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
                            7. Yamauchi FI et al: Multidetector CT evaluation of the postoperative pancreas. Radiographics. 32(3):743-64, 2012
                            8. 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
                            9. Puppala S et al: Hemorrhagic complications after Whipple surgery: imaging and radiologic intervention. AJR Am J Roentgenol. 196(1):192-7, 2011
                            10. Ren S et al: Complications after pancreaticoduodenectomy for pancreatic cancer: a retrospective study. Int Surg. 96(3):220-7, 2011
                            11. Roulin D et al: Systematic review of delayed postoperative hemorrhage after pancreatic resection. J Gastrointest Surg. 15(6):1055-62, 2011
                            12. 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
                            13. 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
                            14. Zureikat AH et al: Can laparoscopic pancreaticoduodenectomy be safely implemented? J Gastrointest Surg. 15(7):1151-7, 2011
                            15. 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
                            16. 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
                            17. 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
                            18. 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
                            19. 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
                            20. 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
                            21. Lytras D et al: Therapeutic strategies for the management of delayed gastric emptying after pancreatic resection. Langenbecks Arch Surg. 392(1):1-12, 2007
                            22. 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
                            23. Topal B et al: Determinants of complications in pancreaticoduodenectomy. Eur J Surg Oncol. 33(4):488-92, 2007
                            24. 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
                            25. Satoi S et al: Less morbidity after pancreaticoduodenectomy of patients with pancreatic cancer. Pancreas. 33(1):45-52, 2006
                            26. Yang YM et al: Risk factors of pancreatic leakage after pancreaticoduodenectomy. World J Gastroenterol. 11(16):2456-61, 2005
                            27. 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

                                                    • Image Interpretation Pearls

                                                      Selected References

                                                      1. Appanraj P et al: CT reporting of relevant vascular variations and its implication in pancreatoduodenectomy. Abdom Radiol (NY). ePub, 2021
                                                      2. Chincarini M et al: Major pancreatic resections: normal postoperative findings and complications. Insights Imaging. 9(2):173-87, 2018
                                                      3. Raman SP et al: CT after pancreaticoduodenectomy: spectrum of normal findings and complications. AJR Am J Roentgenol. 201(1):2-13, 2013
                                                      4. 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
                                                      5. Kunstman JW et al: Comprehensive analysis of variables affecting delayed gastric emptying following pancreaticoduodenectomy. J Gastrointest Surg. 16(7):1354-61, 2012
                                                      6. 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
                                                      7. Yamauchi FI et al: Multidetector CT evaluation of the postoperative pancreas. Radiographics. 32(3):743-64, 2012
                                                      8. 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
                                                      9. Puppala S et al: Hemorrhagic complications after Whipple surgery: imaging and radiologic intervention. AJR Am J Roentgenol. 196(1):192-7, 2011
                                                      10. Ren S et al: Complications after pancreaticoduodenectomy for pancreatic cancer: a retrospective study. Int Surg. 96(3):220-7, 2011
                                                      11. Roulin D et al: Systematic review of delayed postoperative hemorrhage after pancreatic resection. J Gastrointest Surg. 15(6):1055-62, 2011
                                                      12. 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
                                                      13. 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
                                                      14. Zureikat AH et al: Can laparoscopic pancreaticoduodenectomy be safely implemented? J Gastrointest Surg. 15(7):1151-7, 2011
                                                      15. 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
                                                      16. 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
                                                      17. 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
                                                      18. 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
                                                      19. 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
                                                      20. 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
                                                      21. Lytras D et al: Therapeutic strategies for the management of delayed gastric emptying after pancreatic resection. Langenbecks Arch Surg. 392(1):1-12, 2007
                                                      22. 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
                                                      23. Topal B et al: Determinants of complications in pancreaticoduodenectomy. Eur J Surg Oncol. 33(4):488-92, 2007
                                                      24. 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
                                                      25. Satoi S et al: Less morbidity after pancreaticoduodenectomy of patients with pancreatic cancer. Pancreas. 33(1):45-52, 2006
                                                      26. Yang YM et al: Risk factors of pancreatic leakage after pancreaticoduodenectomy. World J Gastroenterol. 11(16):2456-61, 2005
                                                      27. Kimura F et al: Sepsis delays gastric emptying following pylorus-preserving pancreaticoduodenectomy. Hepatogastroenterology. 49(44):585-8, 2002