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- IRMS - Nicolae Testemitanu SUMPh
- REVISTE MEDICALE NEINSTITUȚIONALE
- The Moldovan Medical Journal
- The Moldovan Medical Journal
- The Moldovan Medical Journal 2021
- The Moldovan Medical Journal, Vol. 64, No 1, March 2021
Please use this identifier to cite or link to this item:
http://hdl.handle.net/20.500.12710/16054
Title: | Angioarchitecture of the major duodenal papilla and its relevance for endoscopic sphincterotomy |
Authors: | Pitel, Eleferii Suman, Serghei Gutu, Evghenii |
Keywords: | major duodenal papilla;bleeding;arterial supply;endoscopic retrograde cholangiopancreatography;endoscopic sphincterotomy |
Issue Date: | 2021 |
Publisher: | The Scientific Medical Association of the Republic of Moldova |
Citation: | PITEL, Eleferii, SUMAN, Serghei, GUTU, Evghenii. Angioarchitecture of the major duodenal papilla and its relevance for endoscopic sphincterotomy. In: The Moldovan Medical Journal. 2021, vol. 64, no 1, pp. 76-79. ISSN 2537-6381. DOI: 10.5281/zenodo.4527259 |
Abstract: | Abstract.
Background: The advantages of endoscopic retrograde cholangiopancreatography (ERCP) over traditional surgery for correction of various biliary and
pancreatic pathologies became apparent immediately after its introduction into large clinical practice and today are also not in doubt. ERCP and endoscopic
sphincterotomy (EST) are characterized by efficacy similar to open surgery, but significantly less traumatic, relatively easy, a decrease in the degree of
perioperative surgical and anesthetic risk, and a reduction in the time of in-hospital treatment and postoperative recovery. However, therapeutic ERCP
with EST can be complicated by gastrointestinal bleeding, the degree of which can range from mild to very severe and even life-threatening. Although
the greatest risk for the development of bleeding after EST is caused by preexisting coagulopathy, the anatomical features of the arterial blood supply to
the pancreaticoduodenal region and major duodenal papilla should also be taken into account during the endoscopic procedure.
Conclusions: The communicating artery, directly vascularizing the area of the major duodenal papilla, usually originates from the posterior superior
pancreaticoduodenal artery and entering in the anterior pancreaticoduodenal arcade. The smallest number of papillary arteries, distributed in potential
accessibility to the sphincterotomy incision, is located in the zone between 10 and 11 o’clock of the papilla Vater circumference. Hence, the preferred
performance of EST in this area can be accompanied by a significant reduction in the risk of arterial bleeding after ERCP. |
metadata.dc.relation.ispartof: | The Moldovan Medical Journal |
URI: | http://moldmedjournal.md/wp-content/uploads/2021/03/64-1-0-MMJ-vers-3-martie.pdf http://repository.usmf.md/handle/20.500.12710/16054 |
ISSN: | 2537-6381 2537-6373 |
Appears in Collections: | The Moldovan Medical Journal, Vol. 64, No 1, March 2021
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