title: Emergency pancreaticoduodenectomy in a patient with an ampullary adenocarcinoma associated with severe acute pancreatitis: a case report.
abstract: Emergency pancreatico-duodenectomy is an infrequent surgical procedure. Herein, it is reported the case of a 58-year old man with ampullary carcinoma revealed by acute necrotizing pancreatitis. Due to clinical features, an emergency two-step pancreatico-duodenectomy was performed, accomplished by pancreatic and peripancreatic necrosectomy. The distal remnant pancreas was drained as an external pancreatic fistula. A time later, after complete remittance of local inflammation, the pancreas was anastomosed to the jejunum. The postoperative outcome was uneventful, the patient being disease-free at more than 5 years after surgery. Thus, pancreatico-duodenectomy is a feasible and safe operation when performed in tertiary hepato-bilio-pancreatic centers, in selected cases.
authors.affiliation: Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania. traian.dumitrascu@srchirurgie.ro
authors.forename: T
authors.initials: T
authors.lastname: Dumitraşcu
authors.forename: M I
authors.initials: MI
authors.lastname: Ionescu
authors.forename: L
authors.initials: L
authors.lastname: David
authors.forename: I
authors.initials: I
authors.lastname: Popescu
mesh_terms: D000208:Acute Disease; D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D004638:Emergency Treatment / Q000379:methods*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000379:methods; D010195:Pancreatitis / Q000150:complications*; D016896:Treatment Outcome