Dairy-free on-the-go snacks CT image shows the Cell-regulating foods of hypodense soft tissue white arrow consistent Pancreatic resection Panccreatic recurrence, encasing Dairy-free on-the-go snacks origin of Pancrwatic caeliac trunk and portal vein. A blocked bile duct can make you feel quite unwell. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This is a good time to talk with your care team about any worries you might have.

Pancreatic resection -

Product Editorial Subscription Options Subscribe Sign in. Learn how UpToDate can help you. Select the option that best describes you. View Topic. Font Size Small Normal Large. Surgical resection of lesions of the body and tail of the pancreas.

Formulary drug information for this topic. No drug references linked in this topic. Find in topic Formulary Print Share. View in. Language Chinese English. Authors: Timothy R Donahue, MD Oscar Joe Hines, MD, FACS Section Editor: Stanley W Ashley, MD Deputy Editor: Wenliang Chen, MD, PhD Literature review current through: Jan This topic last updated: Jul 04, Distal pancreatectomy, which removes the body and tail of the pancreas, accounts for approximately 25 percent of all pancreatic resections.

Distal pancreatectomy was first performed by Billroth in Less extensive resections can also be performed in the form of central pancreatectomy, which removes part of the body of the pancreas, or enucleation, which limits the resection to the lesion and immediately adjacent parenchyma.

Exocrine pancreatic secretion is composed of enzymes, water, electrolytes, and bicarbonate, which are delivered to the duodenum via the pancreatic duct of Wirsung and aid with digestion.

Endocrine secretions include insulin, glucagon, and somatostatin from the islets of Langerhans, A cells, and D cells, respectively. Removal of up to 90 percent of the mass of the pancreas can be performed without resulting in diabetes. To continue reading this article, you must sign in with your personal, hospital, or group practice subscription.

See "Overview of surgery in the treatment of exocrine pancreatic cancer and prognosis". The techniques for resection of the body and tail of the pancreas are discussed elsewhere. See "Surgical resection of lesions of the body and tail of the pancreas". The techniques of resection of sporadic pancreatic neuroendocrine tumors are discussed elsewhere.

See "Surgical resection of sporadic pancreatic neuroendocrine tumors". Why UpToDate? Product Editorial Subscription Options Subscribe Sign in. Learn how UpToDate can help you. Select the option that best describes you.

View Topic. Font Size Small Normal Large. Surgical resection of lesions of the head of the pancreas. Formulary drug information for this topic. No drug references linked in this topic.

Find in topic Formulary Print Share. View in. Ann Surg 6 — discussion Article PubMed PubMed Central Google Scholar. Bassi C, Dervenis C, Butturini G et al Postoperative pancreatic fistula: an international study group ISGPF definition. Surgery 1 :8— Faccioli N, Foti G, Molinari E et al Role of fistulography in evaluating pancreatic fistula after pancreaticoduodenectomy.

Br J Radiol 85 — Wente MN, Bassi C, Dervenis C et al Delayed gastric emptying DGE after pancreatic surgery: a suggested definition by the international study Group of Pancreatic Surgery ISGPS. Diener MK, Fitzmaurice C, Schwarzer G et al Pylorus-preserving pancreaticoduodenectomy pp Whipple versus pancreaticoduodenectomy classic Whipple for surgical treatment of periampullary and pancreatic carcinoma.

Cochrane Database Syst Rev Cd PubMed Central Google Scholar. Hüttner FJ, Fitzmaurice C, Schwarzer G et al Pylorus-preserving pancreaticoduodenectomy pp Whipple versus pancreaticoduodenectomy classic Whipple for surgical treatment of periampullary and pancreatic carcinoma.

Cochrane Database Syst Rev 2:Cd PubMed Google Scholar. Limongelli P, Khorsandi SE, Pai M et al Management of delayed postoperative hemorrhage after pancreaticoduodenectomy: a meta-analysis.

Arch Surg 10 — discussion Yekebas EF, Wolfram L, Cataldegirmen G et al Postpancreatectomy hemorrhage: diagnosis and treatment: an analysis in consecutive pancreatic resections. Ann Surg 2 — Wente MN, Veit JA, Bassi C et al Postpancreatectomy hemorrhage PPH : an international study Group of Pancreatic Surgery ISGPS definition.

Surgery 1 — De Cecco CN, Boll DT, Bolus DN et al White paper of the Society of Computed Body Tomography and Magnetic Resonance on dual-energy CT, part 4: abdominal and pelvic applications.

J Comput Assist Tomogr 41 1 :8— Gaujoux S, Sauvanet A, Vullierme MP et al Ischemic complications after pancreaticoduodenectomy: incidence, prevention, and management. Ann Surg 1 — Torabi M, Hosseinzadeh K, Federle MP CT of nonneoplastic hepatic vascular and perfusion disorders. Radiographics 28 7 — Patel NB, Oto A, Thomas S Multidetector CT of emergent biliary pathologic conditions.

Radiographics 33 7 — Miura F, Asano T, Amano H et al Eleven cases of postoperative hepatic infarction following pancreato-biliary surgery. J Gastrointest Surg 14 2 — Ann Chir 6 — Smoot RL, Christein JD, Farnell MB Durability of portal venous reconstruction following resection during pancreaticoduodenectomy.

J Gastrointest Surg 10 10 — Parvey HR, Raval B, Sandler CM Portal vein thrombosis: imaging findings. AJR Am J Roentgenol 1 — Machado NO Pancreatic fistula after pancreatectomy: definitions, risk factors, preventive measures, and management-review.

Int J Surg Oncol Kawai M, Tani M, Terasawa H et al Early removal of prophylactic drains reduces the risk of intra-abdominal infections in patients with pancreatic head resection: prospective study for consecutive patients.

Ann Surg 1 :1—7. Schulick RD Complications after pancreaticoduodenectomy: intraabdominal abscess. J Hepato-Biliary-Pancreat Surg 15 3 — Gouma DJ, van Geenen RC, van Gulik TM et al Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume.

Ann Surg 6 — Koch M, Garden OJ, Padbury R et al Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the international study Group of Liver Surgery.

Melamud K, LeBedis CA, Anderson SW, Soto JA Biliary imaging: multimodality approach to imaging of Biliary injuries and their complications.

Radiographics 34 3 — Kantarcı M, Pirimoglu B, Karabulut N et al Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: comparison with T2-weighted MR cholangiography.

Eur Radiol 23 10 — Brook OR, Abedin S, Mortele KJ Magnetic resonance imaging of the postoperative pancreas. Semin Ultrasound CT MR 34 4 — Bluemke DA, Abrams RA, Yeo CJ, Cameron JL, Fishman EK Recurrent pancreatic adenocarcinoma: spiral CT evaluation following the Whipple procedure.

Radiographics 17 2 — Sperti C, Pasquali C, Piccoli A, Pedrazzoli S Recurrence after resection for ductal adenocarcinoma of the pancreas. World J Surg 21 2 — Sica GT, Ji H, Ros PR CT and MR imaging of hepatic metastases.

Am J Roentgenol 3 — Article CAS Google Scholar. Motosugi U, Ichikawa T, Morisaka H et al Detection of pancreatic carcinoma and liver metastases with Gadoxetic acid—enhanced MR imaging: comparison with contrast-enhanced multi—detector row CT.

Radiology 2 — Hagspiel KD, Neidl KF, Eichenberger AC, Weder W, Marincek B Detection of liver metastases: comparison of superparamagnetic iron oxide-enhanced and unenhanced MR imaging at 1. Radiographics 32 4 — Download references.

Istituto di Radiologia, DAI Patologia e Diagnostica, Verona, Italy. Marco Chincarini, Giulia A. You can also search for this author in PubMed Google Scholar.

Correspondence to Giulia A. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is distributed under the terms of the Creative Commons Attribution 4. Reprints and permissions.

Chincarini, M. Major pancreatic resections: normal postoperative findings and complications. Insights Imaging 9 , — Download citation. Received : 05 September Revised : 03 January Accepted : 05 January Published : 15 February Issue Date : April Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all SpringerOpen articles Search. Download PDF. Original Article Open access Published: 15 February Major pancreatic resections: normal postoperative findings and complications Marco Chincarini 1 , Giulia A.

Abstract Objectives 1 To illustrate and describe the main types of pancreatic surgery; 2 to discuss the normal findings after pancreatic surgery; 3 to review the main complications and their radiological findings. Background Despite the decreased postoperative mortality, morbidity still remains high resulting in longer hospitalisations and greater costs.

Imaging findings CT is the most effective postoperative imaging technique. Conclusions Radiologists should be aware of surgical procedures, postoperative anatomy and normal postoperative imaging findings to better detect complications and recurrent disease.

Surgical background Different surgical procedures are performed based on the type of lesion and its location and can be broadly divided into resection and drainage procedures [ 2 ]. Full size image.

Imaging modalities In the first postoperative period no imaging is required unless complications are suspected. Normal postoperative findings When evaluating a postoperative CT, depending on the type of surgery, the first assessment should be of the anastomoses [ 2 , 4 , 6 , 14 , 15 ]: 1. Axial CT image.

A severely distended stomach filled with fluid and air is evident s. References Whipple AO The rationale of radical surgery for cancer of the pancreas and ampullary region. Ann Surg 4 — Article CAS PubMed PubMed Central Google Scholar Yamauchi FI, Ortega CD, Blasbalg R, Rocha MS, Jukemura J, Cerri GG Multidetector CT evaluation of the postoperative pancreas.

Radiographics 32 3 — Article PubMed Google Scholar Morgan DE Imaging after pancreatic surgery. Radiol Clin N Am 50 3 — Article PubMed Google Scholar Scialpi M, Scaglione M, Volterrani L et al Imaging evaluation of post pancreatic surgery.

Eur J Radiol 53 3 — Article PubMed Google Scholar Zamboni GA, Kruskal JB, Vollmer CM, Baptista J, Callery MP, Raptopoulos VD Pancreatic adenocarcinoma: value of multidetector CT angiography in preoperative evaluation. Radiology 3 — Article PubMed Google Scholar Raman SP, Horton KM, Cameron JL, Fishman EK CT after pancreaticoduodenectomy: spectrum of normal findings and complications.

AJR Am J Roentgenol 1 :2—13 Article PubMed Google Scholar Malleo G, Pulvirenti A, Marchegiani G, Butturini G, Salvia R, Bassi C Diagnosis and management of postoperative pancreatic fistula.

Clin Res Hepatol Gastroenterol 37 3 — Article PubMed Google Scholar Wolfgang CL, Corl F, Johnson PT et al Pancreatic surgery for the radiologist, an illustrated review of classic and newer surgical techniques for pancreatic tumor resection. AJR Am J Roentgenol 6 — Article PubMed Google Scholar Karanicolas PJ, Davies E, Kunz R et al The pylorus: take it or leave it?

Ann Surg Oncol 14 6 — Article PubMed Google Scholar Xiong JJ, Tan CL, Szatmary P et al Meta-analysis of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Br J Surg 10 — Article CAS PubMed Google Scholar Rotman N, Sastre B, Fagniez PL Medial pancreatectomy for tumors of the neck of the pancreas.

Surgery 5 — CAS PubMed Google Scholar Christein JD, Kim AW, Golshan MA, Maxhimer J, Deziel DJ, Prinz RA Central pancreatectomy for the resection of benign or low malignant potential neoplasms. World J Surg 27 5 — Article PubMed Google Scholar Coombs RJ, Zeiss J, Howard JM, Thomford NR, Merrick HW CT of the abdomen after the Whipple procedure: value in depicting postoperative anatomy, surgical complications, and tumor recurrence.

AJR Am J Roentgenol 5 — Article CAS PubMed Google Scholar Johnson PT, Curry CA, Urban BA, Fishman EK Spiral CT following the Whipple procedure: distinguishing normal postoperative findings from complications.

J Comput Assist Tomogr 26 6 — Article PubMed Google Scholar Mortelé KJ, Lemmerling M, de Hemptinne B, De Vos M, De Bock G, Kunnen M Postoperative findings following the Whipple procedure: determination of prevalence and morphologic abdominal CT features. Eur Radiol 10 1 — Article PubMed Google Scholar Thornton E, Mendiratta-Lala M, Siewert B, Eisenberg RL Patterns of fat stranding.

AJR Am J Roentgenol 1 :W1—14 Article PubMed Google Scholar Malleo G, Salvia R, Butturini G et al Is routine imaging necessary after pancreatic resection? Pancreas 43 2 — Article PubMed Google Scholar Pannegeon V, Pessaux P, Sauvanet A, Vullierme MP, Kianmanesh R, Belghiti J Pancreatic fistula after distal pancreatectomy: predictive risk factors and value of conservative treatment.

Arch Surg 11 — discussion Article PubMed Google Scholar DeOliveira ML, Winter JM, Schafer M et al Assessment of complications after pancreatic surgery: a novel grading system applied to patients undergoing pancreaticoduodenectomy.

Ann Surg 6 — discussion Article PubMed PubMed Central Google Scholar Bassi C, Dervenis C, Butturini G et al Postoperative pancreatic fistula: an international study group ISGPF definition. Surgery 1 :8—13 Article PubMed Google Scholar Faccioli N, Foti G, Molinari E et al Role of fistulography in evaluating pancreatic fistula after pancreaticoduodenectomy.

Br J Radiol 85 — Article CAS PubMed PubMed Central Google Scholar Wente MN, Bassi C, Dervenis C et al Delayed gastric emptying DGE after pancreatic surgery: a suggested definition by the international study Group of Pancreatic Surgery ISGPS. Surgery 5 — Article PubMed Google Scholar Diener MK, Fitzmaurice C, Schwarzer G et al Pylorus-preserving pancreaticoduodenectomy pp Whipple versus pancreaticoduodenectomy classic Whipple for surgical treatment of periampullary and pancreatic carcinoma.

Cochrane Database Syst Rev Cd PubMed Central Google Scholar Hüttner FJ, Fitzmaurice C, Schwarzer G et al Pylorus-preserving pancreaticoduodenectomy pp Whipple versus pancreaticoduodenectomy classic Whipple for surgical treatment of periampullary and pancreatic carcinoma.

Cochrane Database Syst Rev 2:Cd PubMed Google Scholar Limongelli P, Khorsandi SE, Pai M et al Management of delayed postoperative hemorrhage after pancreaticoduodenectomy: a meta-analysis.

Arch Surg 10 — discussion Article PubMed Google Scholar Yekebas EF, Wolfram L, Cataldegirmen G et al Postpancreatectomy hemorrhage: diagnosis and treatment: an analysis in consecutive pancreatic resections. Ann Surg 2 — Article PubMed PubMed Central Google Scholar Wente MN, Veit JA, Bassi C et al Postpancreatectomy hemorrhage PPH : an international study Group of Pancreatic Surgery ISGPS definition.

Surgery 1 —25 Article PubMed Google Scholar De Cecco CN, Boll DT, Bolus DN et al White paper of the Society of Computed Body Tomography and Magnetic Resonance on dual-energy CT, part 4: abdominal and pelvic applications. J Comput Assist Tomogr 41 1 :8—14 Article PubMed Google Scholar Gaujoux S, Sauvanet A, Vullierme MP et al Ischemic complications after pancreaticoduodenectomy: incidence, prevention, and management.

Ann Surg 1 — Article PubMed Google Scholar Torabi M, Hosseinzadeh K, Federle MP CT of nonneoplastic hepatic vascular and perfusion disorders.

Radiographics 28 7 — Article PubMed Google Scholar Patel NB, Oto A, Thomas S Multidetector CT of emergent biliary pathologic conditions. Radiographics 33 7 — Article PubMed Google Scholar Miura F, Asano T, Amano H et al Eleven cases of postoperative hepatic infarction following pancreato-biliary surgery.

Ann Chir 6 — Article CAS PubMed Google Scholar Smoot RL, Christein JD, Farnell MB Durability of portal venous reconstruction following resection during pancreaticoduodenectomy. J Gastrointest Surg 10 10 — Article PubMed Google Scholar Parvey HR, Raval B, Sandler CM Portal vein thrombosis: imaging findings.

AJR Am J Roentgenol 1 —81 Article CAS PubMed Google Scholar Machado NO Pancreatic fistula after pancreatectomy: definitions, risk factors, preventive measures, and management-review.

Int J Surg Oncol PubMed Google Scholar Kawai M, Tani M, Terasawa H et al Early removal of prophylactic drains reduces the risk of intra-abdominal infections in patients with pancreatic head resection: prospective study for consecutive patients.

Ann Surg 1 :1—7 Article PubMed PubMed Central Google Scholar Schulick RD Complications after pancreaticoduodenectomy: intraabdominal abscess. J Hepato-Biliary-Pancreat Surg 15 3 — Article Google Scholar Gouma DJ, van Geenen RC, van Gulik TM et al Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume.

Ann Surg 6 — Article CAS PubMed PubMed Central Google Scholar Koch M, Garden OJ, Padbury R et al Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the international study Group of Liver Surgery.

Surgery 5 — Article PubMed Google Scholar Melamud K, LeBedis CA, Anderson SW, Soto JA Biliary imaging: multimodality approach to imaging of Biliary injuries and their complications. Radiographics 34 3 — Article PubMed Google Scholar Kantarcı M, Pirimoglu B, Karabulut N et al Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: comparison with T2-weighted MR cholangiography.

Eur Radiol 23 10 — Article PubMed PubMed Central Google Scholar Brook OR, Abedin S, Mortele KJ Magnetic resonance imaging of the postoperative pancreas.

Resectio into Imaging volume Lentils and lentil-based dessertspages — Cite this article. Metrics details. Despite the Resechion postoperative mortality, morbidity still remains high resulting Resdction longer reseection and greater costs. The former should regress within a few months whereas complications may be life-threatening and should be promptly identified and treated. CT is the most effective postoperative imaging technique. MRI and fluoroscopy are used less often and only in specific cases such as assessing the gastro-intestinal function or the biliary tree. Imaging depicts the anastomoses and the new postoperative anatomy.