Search results for " Vater"

AMPULLECTOMIA E CARCINOMA GIGANTE DELLA PAPILLA DI VATER

2007

The case of a giant carcinoma of Vater's papilla is reported. The clinical/diagnostic paths and therapeutic indications for ampullectomy are analysed on the basis of the good survival rate observed more than five years after transduodenal excision and in the light of the most recent literature. The authors believe that accurate, early diagnosis and histological typing is fundamental for an appropriate selection of patients when complex surgical decisions have to be taken. They consider ampullectomy to be a valid therapeutic option, certainly in the case of benign neoplasias, and duodenocephalopancreasectomy (DCP) to be the operation of choice for the treatment of ampullar and periampullar m…

Endoscopic therapy of adenomas of the papilla of Vater. A retrospective analysis with long-term follow-up.

2001

Abstract Aims. To compare the efficacy and the complication rate between endoscopic snare resection of adenomas of Vater's papilla and endoscopic palliation. Methods. In a retrospective, non randomized manner, we compared long-term results of our endoscopic strategies in 36 patients with histologically confirmed adenoma of Vater's papilla submitted either to local endoscopic snare resection (n=18) or to simple endoscopic palliation (n=18), respectively. Results. Between 1985 and 1998 results were reviewed. Median age was 76.5 (range 42–89) years in the palliation, and 64.0(23–89) years in the endoscopic snare resection group. Median duration of follow-up was 33 (6–135) and 75.0 (27–123) mon…

Treatment of tumors of the pancreatic head with suspected but unproved malignancy: is a nihilistic approach justified?

1999

The aim of the present prospective observational study was to evaluate the accuracy of preoperative imaging studies and the outcome of patients after pancreaticoduodenectomy for suspected but unproved malignancy. Pancreaticoduodenectomy was performed in 186 patients with a suspected but histologically unproved malignancy of the pancreatic head: 86 with a ductal pancreatic carcinoma, 56 with a periampullary tumor, 18 with a cystadenocarcinoma, 13 with a rare malignant tumor or a metastasis, and 13 with a benign tumor. An accurate differentiation between a ductal pancreatic carcinoma and a nonductal tumor or a benign tumor was neither possible with tumor marker CA 19-9 nor with diagnostic ima…

Promyelocytic leukemia (PML) gene expression is a prognostic factor in ampullary cancer patients

2008

Background: Promyelocytic leukemia (PML) tumor suppressor gene plays a key role in acute PML pathogenesis but its involvement in pathogenesis and prognosis of solid cancers has not been defined yet. Patients and methods: In all, 62 ampullary adenocarcinoma patients who underwent curative surgery between 1996 and 2005 were included. Expression analysis of PML was carried out by immunohistochemical staining and correlated with disease-free survival (DFS) and overall survival (OS). Results: In 24 tumor specimens (38.7%), PML was classified as absent, in 16 (25.8%) as focally expressed and in 22 (35.5%) as diffusely expressed. By univariate analysis, DFS was significantly influenced by patholog…

Perineural Invasion is a Strong Prognostic Moderator in Ampulla of Vater Carcinoma

2018

Objective Ampulla of Vater carcinoma (AVC) has a broad spectrum of different prognoses. As such, new moderators of survival are urgently needed. We aimed at clarifying the prognostic role of perineural invasion in AVC. Methods Using PubMed and SCOPUS databases, we conducted the first systematic review and meta-analysis on this topic. Results Analyzing 29 articles for a total of 2379 patients, we found that the presence of perineural invasion increased the risk of all-cause mortality more than 2 times (relative risk [RR], 2.07; 95% confidence interval [CI], 1.78-2.42 [P < 0.0001]; hazard ratio [HR], 2.72; 95% CI, 1.86-3.97 [P < 0.0001]), of cancer-specific mortality more than 6 times (…

NITROGLYCERINE DILATATION OF SPHINCTER OF ODDI FOR ENDOSCOPIC REMOVAL OF BILEDUCT STONES

1984

PENTAZOCINE HAMPERS BILE FLOW

1985

Pharmacology of the Sphincter of Oddi

1988

The sphincter of Oddi is the smooth muscle connection between the bile duct and the duodenum. Its physiological function is associated with a regular motility characterized by phasic contractions superimposed on the sphincter of Oddi baseline pressure. Recently introduced ERCP-manometry permits further studies of sphincter of Oddi pharmacology. A number of drugs have so far been studied. Sedatives of the diazepam type had no effect on the sphincter, while butylscopolaminium bromide, a typical neurotropic agent, brings about cessation of the sphincter motility for 3-8 minutes. Hymecromon lowered the sphincter baseline pressure from 9.8 to 7.8 mmHg. A 1.2 mg sublingual dose of nitroglycerin, …

Esophageal atresia in newborns: a wide spectrum from the isolated forms to a full VACTERL phenotype?

2013

Background: VATER association was first described in 1972 by Quan and Smith as an acronym which identifies a non-random co-occurrence of Vertebral anomalies, Anal atresia, Tracheoesophageal fistula and/or Esophageal atresia, Radial dysplasia. It is even possible to find out Cardiovascular, Renal and Limb anomalies and the acronym VACTERL was adopted, also, embodying Vascular, as single umbilical artery, and external genitalia anomalies. Methods: Data on patients with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) admitted in the Neonatal Intensive Care Unit (NICU) between January 2003 and January 2013 were evaluated for the contingent occurrence of typical VACTERL a…

Endoscopic papillary large balloon dilation in patients with large biliary stones and periampullary diverticula: Results of a multicentric series.

2018

Abstract Introduction Stone extraction represents the most frequent indication for endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic papillary large balloon dilation (EPLBD) is a recent introduced approach consisting of an endoscopic papillary large balloon dilation following limited endoscopic sphyncterotomy (ES), which has been proven to be safe and effective for extraction of large common bile duct (CBD) stones. Peri-ampullary diverticula (PAD) are described in 10–20% of patients undergoing ERCP. Aim of our study is to evaluate efficacy and safety of EPLBD for the extraction of large biliary stones in patients with PAD. Methods The prospectively collected endoscopy databa…