Preoperative Imaging

All patients require preoperative imaging studies to help with decisions about the kind of operation that may be indicated. The goals of imaging are (1) to assess the diameter of the duct, (2) to determine the presence of any associated disease (eg, cysts, bile duct obstruction), and (3) to search for an unsuspected pancreatic malignancy. All patients should undergo a high resolution computed tomography (cT) scan with fine cuts through the pancreas during the arterial phase of the study. Endoscopic ultrasound (EUS) with fine needle aspiration (FNA) of any suspicious area may be indicated if the results of the CT scan raise a question about malignancy. There is a separate chapter on EUS and FNA (see Chapter 5, "Endoscopic Ultrasonography and Fine-Needle Aspiration").

Operations to relieve pain in these patients either (1) drain a dilated pancreatic ductal system or (2) resect diseased pancreatic tissue if the duct is not enlarged. The main pancreatic duct normally measures 4 to 5 mm in the head, 3 to 4 mm in the body, and 2 to 3 mm in the tail of the pancreas. The duct is considered dilated when it is at least 7 mm in diameter in the body of the gland.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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