This portion is not done en bloc, as the gallbladder is removed separately. During the surgery a cholecystectomy is performed to remove the gallbladder. The surgeon will make a new attachment between the pancreatic duct and the jejunum or stomach. This means that while the liver remains with a good blood supply the surgeon must make a new connection to drain bile produced in the liver. While blood supply to the liver is left intact, the common bile duct is removed. If only the head of the pancreas were removed it would compromise blood flow to the duodenum, resulting in tissue necrosis. These arteries run through the head of the pancreas, so that both organs must be removed if the single blood supply is severed. The reason for the removal of the duodenum along with the head of the pancreas is that they share the same arterial blood supply (the superior pancreaticoduodenal artery and inferior pancreaticoduodenal artery). There are additional smaller branches given off by the right gastric artery which is also derived from the celiac artery. The vascular supply of the pancreas is from the celiac artery via the superior pancreaticoduodenal artery and the superior mesenteric artery from the inferior pancreaticoduodenal artery. This is an important first step as the presence of active metastatic disease is a contraindication to performing the operation. Īt the very beginning of the procedure, after the surgeons have gained access to the abdomen, the surfaces of the peritoneum and the liver are inspected for disease that has metastasized. However, not all lymph nodes are removed in the most common type of pancreaticoduodenectomy because studies showed that patients did not benefit from the more extensive surgery. Lymph nodes in the area are often removed during the operation as well (lymphadenectomy). More information will follow.The most common technique of a pancreaticoduodenectomy consists of the en bloc removal of the distal segment (antrum) of the stomach, the first and second portions of the duodenum, the head of the pancreas, the common bile duct, and the gallbladder. The second Bach Academy will happen in July 2024 in Modena, Italy. The Academy orchestra rehearsed and performed pieces of Johann Sebastian Bach and his sons (Wilhelm Friedemann Bach,Ĭarl Philipp Emanuel Bach, Johann Christoph Frederic Bach as well as Johann Christian Bach).Ī more detailed description of the Bach-Academy and concerts can be found at Notenspur Leipzig's website. Theįinal concert of the Bach Academy happened in Lyon on Sunday, November 20th. John's Passion) on Wednesday, November 16th, and played a concert in Leipzig's Old Stock Exchange (Leipzig's oldest baroque building) on Friday, November 18th. Nicolas Church (where Bach premiered many of his cantatas as well as hisĬhristmas Oratorio and St. Influenced Bach's compositions from historic dance instructor Nicolle Klinkeberg. Additionally, they had the chance to learn baroque dances that have Karkow (2nd violins and violas), Aude Walker-Viry (celli & double bass) and Ines Laue (German pronunciation for singers). 18 students of early music and 3 singers from Germany, Italy and France were invitedĪfter an application process to participate under the tutelage of Franck-Emmanuel Comte (conducting, singers & continuo coaching), Reynier Guerrero (1st violins and traverso), Mechthild BACH ACADEMY – Master Classes for Students of Early Music & Concerts The first Bach Academy happened from November 14th to 18th, 2022 in Leipzig.
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