Pancreas divisum. Correlation between anatomical abnormalities and bile precipitation in the gallbladder in seven patients

Pancreas divisum is a genetic defect associated with recurrent acute pancreatitis due to insufficient drainage of the accessory pancreatic duct. Seven young patients diagnosed with pancreatic divisum and thickening of the gallbladder bile as shown on magnetic resonance cholangio-pancreatography without pancreatic ductal changes underwent laparoscopic cholecystectomy. During the mean follow-up of 32 months no episode of pancreatitis was reported. There is an association between PD and higher concentration of bile in the gallbladder. Cholecystectomy can be considered curative in patients with PD in the absence of indications for major surgery

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Integrated Loregional therapies in surgery The Loco-regional therapies are a series of special methods that are able to bring, by means of surgery or radiological interventistic procedures, alone or combined, high doses of one or more antiblastic drugs, that concentrate at the sites of neoplasia, avoiding systemic damages to the organism. They are defined “integrated” because they belong to a complex and definitive treatment of a tumor (surgical treatment, loco-regional therapies, systemic chemotherapy) that is performed mostly for neoplasias that where considered inoperable until today, such as hepatic metastases, advanced pancreatic tumors, peritoneal carcinosis, tumor recurrence, operable only by means of radical surgery, The experiences maturated until today have developed new knowledge in the field of oncology and have opened up new horizons that let us believe that in the next future, some of these methods may be used as “neoadjuvants” in order to render previously inoperable tumors operable, or to perform more conservative operations, in those cases in which till now it is possible to perform only fully radical and disabling surgery. It is plain that these types of aid concern a great variety of clinical situations and involves a remarkable heterogeneity of sanitary operators, belonging to thoroughly different disciplines and competencies (surgeons, anaesthetists, radilogists, oncologists, nutritionists, nephrologists), whose cultural preparation in the field of Loco-regional integrated treatment in surgery is often empirical and autodidactic. The aim of the Collaburation is to provide sanitary operators involved in this field with a thorough, organic, complete, theoretical and practical analysis of their knowledge, in order to deal personally with the variform clinical indication and management problems of these treatment techniques.facolta di medicina ed odontoiatria dipartimento di chirurgia P. valdoni