title: Successful emergency pancreatoduodenectomy in a non-trauma patient.
abstract: In the past decades considerable improvements in diagnostic imaging procedures, surgical technique and perioperative intensive care treatment have lead to a significant decrease in perioperative mortality and morbidity after pancreatic resection. This lead to an expansion of the indications for pancreatoduodenectomy. Little data exist in the literature on emergency pancreatoduodenectomy in non-trauma patients. We present a 43-year-old woman with extensive bleeding from papilla of Vater after endoscopic retrograde cholangiopancreatography (ERCP) with papillosphincterotomy. During the surgical exploration a tumor mass on the head of the pancreas was observed and a pancreatoduodenectomy was performed. On day 7 after the operation pancreatic leakage was observed and conservative therapy was administrated. Two weeks later the patient was released from the hospital in good health. Emergency pancreatoduodenectomy may be considered in institutions with extensive experience in these procedures, where cooperation of the invasive gastroenterologists and the abdominal surgeons, long experience of the surgeon and intensive reanimation care are present.
authors.affiliation: Clinic of Hepato-Biliary and Pancreatic Surgery, Military Medical Academy, Sofia, Bulgaria. vladovkoko@abv.bg
authors.forename: Nikola Nikolov
authors.initials: NN
authors.lastname: Vladov
authors.forename: Ivelin Rumenov
authors.initials: IR
authors.lastname: Takorov
authors.forename: Ventsislav Metodiev
authors.initials: VM
authors.lastname: Mutafchiiski
authors.forename: Kirien Tzvetanov
authors.initials: KT
authors.lastname: Kjossev
authors.forename: Krum
authors.initials: K
authors.lastname: Kazarov
authors.forename: Nikolai
authors.initials: N
authors.lastname: Mladenov
authors.forename: Nikolai
authors.initials: N
authors.lastname: Petrov
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D004386:Duodenum / Q000601:surgery; D004630:Emergencies; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000601:surgery*; D010179:Pancreas / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome