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匹配条件： “Pancreatic Duct” ，找到相关结果约1000条。
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Multidisciplinary Management of Pancreatic Head Adenocarcinoma Presenting with Painless Obstructive Jaundice [PDF]
Ebiuwa Osula, Muhammad Ali, Ritesh Pahwani, Bhavtosh Dedania
Open Journal of Gastroenterology (OJGas) , 2026, DOI: 10.4236/ojgas.2026.162008

Abstract: Background: Pancreatic ductal adenocarcinoma (PDAC) often presents late with nonspecific symptoms, particularly in elderly patients with multiple comorbidities. The “double-duct sign”, characterized by simultaneous dilation of the common bile duct (CBD) and main pancreatic duct (PD), is a radiologic indicator of pancreatic head or peri-ampullary malignancy. Multidisciplinary management is critical to optimize diagnostic accuracy, therapeutic interventions, and patient-centered care. Case Presentation: An 82-year-old female with a history of cerebrovascular accident, hypothyroidism, asthma, osteoarthritis, migraine headaches, gastroesophageal reflux disease, and prior cholecystectomy presented with early satiety, progressive unintentional weight loss over several months, and visible jaundice noted by a friend. Laboratory evaluation revealed marked hyperbilirubinemia and significantly elevated CA 19-9 (~2390 U/mL). Imaging demonstrated a dilated CBD and PD consistent with the double-duct sign and a small mass in the head/uncinate process of the pancreas. ERCP with stent placement relieved the obstruction. EUS-guided fine-needle biopsy confirmed adenocarcinoma. Multidisciplinary involvement, including Gastroenterology, Surgical Oncology, Hematology/Oncology, Pulmonology, Nutrition, and Palliative Care, guided staging, aspiration risk management due to severe esophageal dysmotility, nutritional optimization, and goals-of-care planning. Conclusion: Early recognition of subtle clinical signs, timely endoscopic tissue acquisition, and coordinated multidisciplinary care are essential in managing elderly patients with pancreatic head adenocarcinoma. Comprehensive management mitigates complications, addresses quality-of-life concerns, and aligns treatment with patient-centered goals.

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Pancreatic Body Fracture does not Necessarily Imply Loss of Ductal Integrity Following Blunt Trauma Abdomen—A Rare Image [PDF]
Disha Syal, Arindam Ghosh
Surgical Science (SS) , 2011, DOI: 10.4236/ss.2011.25054

Abstract: Pancreatic injuries can result in significant morbidity and mortality if missed or unnoticed and also pose a great challenge in terms of diagnosis and treatment. We present a case of an 11 year old boy presenting with history of blunt trauma abdomen following handle bar injury. He had signs of abdominal distension and CECT of the abdomen showed transection of the pancreas in the region of junction between the body and tail. On exploratory laparotomy there was rupture at junction of body and tail of pancreas with intact pancreatic duct and a spleen preserving distal pancreatectomy was performed. In the presence of an intact pancreatic duct conservative management should be offered however this patient underwent spleen preserving distal pancreatectomy because of pancreatitis and necrosis ensuing in the pancreatic remnant margin. Hence, complete transection does not necessarily mean loss of ductal integrity and decision to preserve or remove the distal pancreas should not be based merely on ductal integrity but probably other factors also i.e. pancreatitis and necrosis.

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Pancreatic Ductal Bicarbonate Secretion: Challenge of the Acinar Acid Load
Péter Hegyi,Viktória Venglovecz
Frontiers in Physiology , 2011, DOI: 10.3389/fphys.2011.00036

Abstract: Acinar and ductal cells of the exocrine pancreas form a close functional unit. Although most studies contain data either on acinar or ductal cells, an increasing number of evidence highlights the importance of the pancreatic acinar-ductal functional unit. One of the best examples for this functional unit is the regulation of luminal pH by both cell types. Protons co-released during exocytosis from acini cause significant acidosis, whereas, bicarbonate secreted by ductal cells cause alkalization in the lumen. This suggests that the first and probably one of the most important role of bicarbonate secretion by pancreatic ductal cells is not only to neutralize the acid chyme entering into the duodenum from the stomach, but to neutralize acidic content secreted by acinar cells. To accomplish this role, it is more than likely that ductal cells have physiological sensing mechanisms which would allow them to regulate luminal pH. To date, four different classes of acid-sensing ion channels have been identified in the gastrointestinal tract (transient receptor potential ion channels, two-pore domain potassium channel, ionotropic purinoceptor and acid-sensing ion channel), however, none of these have been studied in pancreatic ductal cells. In this mini-review, we summarize our current knowledge of these channels and urge scientists to characterize ductal acid-sensing mechanisms and also to investigate the challenge of the acinar acid load on ductal cells.

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Endoscopic retrieval of a migrated pancreatic stent under direct？pancreatoscopy by use of a “snare over in-stent wire？guide”？method
- , 2018, DOI: 10.1016/j.vgie.2018.06.004

Abstract:

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Current Status and Perspectives of External Versus Internal Pancreatic Duct Drainage during the Learning Curve of Laparoscopic Pancreaticoduodenectomy [PDF]
Shicheng Gong, Shijia Li, Shuai Wang
Journal of Biosciences and Medicines (JBM) , 2024, DOI: 10.4236/jbm.2024.129005

Abstract: Objectives: To summarize the current status and outlook of pancreatic duct drainage in the learning curve period of laparoscopic pancreaticoduodenectomy (LPD). Methods: By searching the literature related to the efficacy analysis of internal versus external pancreatic duct drainage in pancreaticoduodenectomy (OPD) and the learning curve period of laparoscopic pancreaticoduodenectomy in recent years at home and abroad and making a review. Results: Because of the complexity of the LPD surgical procedure, the high technical requirements and the high complication rate, it is necessary for the operator and his/her team to carry out a certain number of cases to pass through the learning curve in order to have a basic mastery of the procedure. In recent years, more and more pancreatic surgeons have begun to promote and use pancreatic duct drains. However, no consensus conclusion has been reached on whether to choose internal or external drainage for pancreatic duct placement and drainage in LPD. Conclusions: Intraoperative application of pancreatic duct drainage reduces the incidence of pancreatic fistula during the learning curve of laparoscopic pancreaticoduodenectomy. However, external pancreatic duct drainage and internal pancreatic duct drainage have both advantages and disadvantages, so when choosing the drainage method, one should choose the appropriate drainage method in conjunction with one’s own conditions, so as to reduce the incidence of complications.

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Endoscopic resection of an unusual ampullary adenoma
- , 2019, DOI: 10.1016/j.vgie.2019.03.012

Abstract:

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Biliary ascariasis: mimicker of biliary stent
- , 2017, DOI: 10.1016/j.vgie.2017.04.001

Abstract:

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Transpapillary incision of refractory circumscript pancreatic duct stricture using wire-guided snare forceps
Takao Itoi, Atsushi Sofuni, Fumihide Itokawa, Toshio Kurihara, Takayoshi Tsuchiya, Kentaro Ishii, Shujiro Tsuji, Nobuhito Ikeuchi, Fuminori Moriyasu
World Journal of Gastroenterology , 2010,

Abstract: Endoscopic therapy of pancreatic duct (PD) strictures using balloon dilation and pancreatic duct stent (PS) placement has been reported to improve the severity of abdominal pain in selected patients with chronic pancreatitis (CP). However, some strictures are refractory and require frequent PS exchange to control symptoms. We describe two cases of successful endoscopic PD incision for difficult PD stricture using a wire-guided snare. The snare is partially opened within the strictured pancreatic duct while applying current, thus incising the duct. Although both cases were successful without complications we do not advocate that this method be used routinely because of the potential for severe complications, e.g. bleeding, ductal perforation or pancreatic parenchymal damage. In order to prevent these complications, we developed a wire-guided technique under fluoroscopic control. We think this procedure may be useful in patients with short, straight PD strictures. Although further study is required, this approach may have potential for selected patients with refractory PD strictures due to CP.

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Endoscopic rescue therapy of a distally perforated, retroperitoneal stent after EUS-guided pancreaticogastrostomy
- , 2019, DOI: 10.1016/j.vgie.2019.01.002

Abstract:

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Acute pancreatitis: Etiology and common pathogenesis
Guo-Jun Wang, Chun-Fang Gao, Dong Wei, Cun Wang, Si-Qin Ding
World Journal of Gastroenterology , 2009,

Abstract: Acute pancreatitis is an inflammatory disease of the pancreas. The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide. Many causes of acute pancreatitis have been discovered, but the pathogenetic theories are controversial. The most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic duct. The majority of investigators accept that the main factors for acute billiary pancreatitis are pancreatic hyperstimulation and bile-pancreatic duct obstruction which increase pancreatic duct pressure and active trypsin reflux. Acute pancreatitis occurs when intracellular protective mechanisms to prevent trypsinogen activation or reduce trypsin activity are overwhelmed. However, little is known about the other acute pancreatitis. We hypothesize that acute biliary pancreatitis and other causes of acute pancreatitis possess a common pathogenesis. Pancreatic hyperstimulation and pancreatic duct obstruction increase pancreatic duct pressure, active trypsin reflux, and subsequent unregulated activation of trypsin within pancreatic acinar cells. Enzyme activation within the pancreas leads to auto-digestion of the gland and local inflammation. Once the hypothesis is confirmed, traditional therapeutic strategies against acute pancreatitis may be improved. Decompression of pancreatic duct pressure should be advocated in the treatment of acute pancreatitits which may greatly improve its outcome.

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