Applied Surgical Anatomy
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
The patient has no distant metastases. Pancreas cancer is resectable. Would you relieve jaundice before surgery or proceed with surgery directly?Operating on patients with jaundice has risks of coagulopathy, renal dysfunction, and wound or abdominal sepsis.Preoperative biliary drainage with ERCP and biliary stenting is an option in patients with deep jaundice. However, it is associated with an increased risk of abdominal and wound sepsis. Hence, its routine use is not advocated. It is indicated when neoadjuvant chemotherapy is planned.Preoperative biliary drainage with PTC is an option; however, this is inconvenient to the patient, not physiologic, leads to fluid-electrolyte deficits, and does not restore enterohepatic circulation.In patients with preoperative biliary drainage, surgery should be deferred for up to 14 days for immune benefits to be restored from enterohepatic circulation and nutritional rehabilitation.
Abdominal surgery
Roy Palmer, Diana Wetherill in Medicine for Lawyers, 2020
Some understanding of the function of the abdominal organs is important. The oesophagus transmits food from the mouth to the stomach. It has no digestive function, although a number of medical conditions affect the oesophagus and make it difficult to swallow. The stomach acts as a reservoir; it produces dilute hydrochloric acid which initiates digestion. The liver is responsible for metabolizing digested food products. Bile, an emulsifying agent which aids digestion, is produced in the liver and concentrated in the gallbladder. When a particularly fatty meal is digested, the gallbladder contracts squeezing bile into the bile ducts and then into the duodenum, the first part of the small bowel. The food becomes emulsified with the bile and digestion is initiated. The pancreas produces enzymes that aid digestion. These enzymes are particularly caustic and if they escape from the pancreas can cause severe inflammation (pancreatitis). The pancreas also has one other function and that is sugar regulation; it produces insulin.
The Digestive (Gastrointestinal) System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
The pancreas, located behind the stomach, contains digestive exocrine cells in addition to its endocrine function. Pancreatic enzymes are capable of digesting fats, carbohydrates, and proteins, and they are carried by an alkaline bicarbonate solution that neutralizes stomach acid. These juices act to convert the chemical environment from acidic to alkaline, which is more amenable to the intestines. Although the liver lies outside the digestive tract, it is considered a part of this system because of its many functions relating to digestion. It modifies all types of food substances, including fats, to enable utilization by body tissues. The gallbladder, a small, pear-shaped, sac-like organ located under the right lobe of the liver, serves as a storage area for excess bile before it passes into the duodenum.
Horticultural crops as natural therapeutic plants for the therapy of diabetes mellitus
Published in Egyptian Journal of Basic and Applied Sciences, 2023
Balikis Oluwakemi Mustapha, Olufemi Temitope Ademoyegun, Rabiat Shola Ahmed
Diabetes mellitus is a long-term metabolic disorder that occurs as a result of the body’s inability to produce or use insulin and this affects human physical, social and psychological health. The pancreas produces insulin in the body which helps to convey blood sugar from the bloodstream to the cells which further breaks down and is used as fuel for normal body metabolism. The disease is typically attributed to lack of glucose homeostasis brought on by errors in insulin production or activity which in turn result in an improper metabolism of glucose and other sources of energy like protein and lipid. This is frequently accompanied by a loss of energy and body weight as well as significant alterations in lipid metabolism. Diabetes can cause serious side effects such as blindness, stroke, heart attack, liver malfunction, nerve damage and kidney failure if it is not treated properly [2]. They occur in two types, namely, Type 1 (also known as Juvenile type) which is insulin-dependent and hereditary. It is an autoimmune disease in which the immune system accidentally attacks the insulin-producing cells of the pancreas. This type is common in children and adolescents.
Emerging kinase inhibitors for the treatment of pancreatic ductal adenocarcinoma
Published in Expert Opinion on Emerging Drugs, 2022
NCI’s Surveillance, Epidemiology, and End Results (SEER) program estimates a total of 62,210 new cases of pancreatic cancer (3.2% of all cancer diagnoses in the U.S.) and 49,830 deaths (8.2% of all cancer-related deaths) in the U.S. in 2022 [1]. Pancreas cancer is one of the few solid organ cancers with currently rising incidence rates [2–4]. Based on projected shifts in demographics and changes in estimated incidence and death rates, pancreas cancer is projected to surpass breast, prostate, and colorectal cancer to become the second leading cause of cancer-related mortality in the U.S [2]. Age-adjusted incidence rates for new pancreas cancer cases and pancreas cancer-related death rates have risen by an average of 0.5% and 0.2% per year over the last decade, and projected incidence and death rates are estimated to increase to 1.3% and 0.5% annually, respectively [1,2]. Based on 2017 to 2019 data, the life-time risk of men and women to be diagnosed with pancreas cancer is ~1.7% [1].
Introduction to a special issue of the International Journal of Hyperthermia: “the status and prospects of the clinical applications of high intensity focused ultrasound”
Published in International Journal of Hyperthermia, 2021
Since the pancreas is a retroperitoneal organ, pancreatic cancer can have an insidious onset. By the time of diagnosis, 80% of patients are non-operable with a poor prognosis. HIFU treatment of pancreatic cancer has a 20-year history already. Previous studies showed that in 85 % of HIFU treated patients with late-stage pancreatic cancer, long-lasting pain relief was achieved. The median overall survival and progression-free survival were 16.2 and 16.9 months from diagnosis and 8.3 and 6.8 months from intervention [24,25]. HIFU can prolong patient survival and improve quality of life. For borderline pancreatic cancers, HIFU can lower tumor grade, which can give the patients an opportunity to participate in radical surgery. Articles from Germany and Bulgaria in this special issue present recent findings in regards to HIFU treatment of pancreatic cancer [26,27].
Related Knowledge Centers
- Digestive System
- Exocrine Gland
- Abdominal Cavity
- Endocrine System
- Stomach
- Digestive System
- Gland
- Heterocrine Gland
- Endocrine Gland
- Blood Sugar Level
- Hormone