Cistoadenoma seroso microquisto del pancreas aspectos clinicopatologicos y quirurgicos / Microcystic serous cystadenoma of pancreas. Clinicopathological and surgical features

The microcystic serous cystadenoma of pancreas or glycogen "rich"cystadenoma is a rare entity. Whe studiet five case of this cystadenoma in adult patients ages 47-68 (58 was the mean), four of wich were women (80 percent). The clinical presentation was varied. There was a prevalence of expansive manifestations with epigastric pain in three patients, and extrahepatic bile duct obstruction in other two. A distal tumour was revealed by the diagnostic methodology used (ultrasound and TAC) in three patients, and cephalic tumour in two, with a mean size of 8.8 cm. in diameter. A distal pancreatectomy was performed in two patients, a cephalic pancreatoduodenectomy was performed in one in relation with the presence of extrahepatic bile duct carcinoma, and the other two were treated with a partial cephalic pancreatectomy (enucleation). The nosological diagnose was post-surgical in all case of study. a prognosis for every case was dependat of the associated pathology.

Reintervenciones en las vias biliares por litiasis. Nuestra tactica de eleccion para el abordaje del hepatocoledoco via antro piloro duodenal. / Reoperations on the bile ducts for lithiasis.Elective method of approach to the hepatocholedochus by duodenal piloric antrum way

Los autores proponen en las reintervenciones quirurgicas por una litiasis de la via biliar principal un abordaje desde el sector izquierdo de la cara inferior del higado. Basados en conceptos anatomopatologicos senalan que la region subhepatica derecha, es mas conflictiva por el bloqueo adherencial, por lo cual preconizan una via de despegamiento antropiloroduodenal, de izquierda a derecha.Destacan que en las reintervenciones biliares todas las vias se complementan, y por ello los autores no excluyen otros enfoques