Pancreas-Preserving Approach to “Paraduodenal Pancreatitis” Treatment: Why, When, and How? Experience of Treatment of 62 Patients with Duodenal Dystrophy
Figure 7
Removed pancreaticoduodenal specimen. (a) Patient 53 y.o. Duodenal dystrophy with chronic orthotopic pancreatitis. Ectopic pancreas within the medial wall of the duodenum (arrow) 1 cm from the main duodenal papilla (wide arrow) with a probe passed through the common bile duct and pancreatic duct; (b) and (c) macrophotograph. Section through the ectopic pancreas. The duodenal wall (arrow) separates the ectopic gland (wide arrow) and the head of the orthotopic pancreas (asterisk) with severe chronic inflammation. The ampulla of Vater (arrowhead) is 0.5 cm from the heterotopic gland; (d) patient 43 y.o. Duodenal dystrophy with moderate chronic pancreatitis in the main pancreas. The probe is passed through the ampulla of Vater. Septated cysts 0.5–1.5 cm in diameter (triple arrow) in the duodenal wall are isolated from the head of pancreas; (e) patient 34 y.o. Duodenal dystrophy with moderate chronic pancreatitis in the main pancreas (asterisk). The second portion of the duodenum is transversely dissected (two-headed arrow). The cyst up to 5 cm in diameter is spread along the whole duodenal wall (triple arrow).
