SUMMARY AND CONCLUSIONPreservation of the gastric antrum and pylorus during pancteaticoduodenectomy represents one of the recent advances in pancreatic surgery and is on example of the modern surgical proposal to respect human physiology as much as possible.This study was conducted in general surgery department, Zagazig university hospital between September 2004 and December 2005 on 23 patients presented with pancreatic cancer. 12 patients (52.2%) underwent PPPD and 11 patients (47.8 %) the Whipple procedure.In this study, there were no significant differences in the age, sex, tumor localization and staging between both groups.There was no significant difference between PPPD and the Whipple operation in terms of operating time, blood loss, hospital stay and blood transfusion. Both PPPD and the Whipple procedure were associated with a low mortality rate and few major operative complications. PPPD was associated with more frequent delayed gastric emptying, although more patients are needed to demonstrate this conclusively.Pylorus-preserving pancreaticoduodenectomy has operative mortality and morbidity rates more or less similar to those seen with the standard Whipple resection and does not impair radicality in the treatment of pancreatic cancer. It probably offers long-term digestive function in patients with pancreatic cancer that was reflected by better nutritional results.We conclude that PPPD represents an important advance in the history of pancreatic surgery. the operation has comparable results with the standard Whipple resection. Although delayed gastric emptying may be more frequently seen with PPPD, this complication is easily managed, and is hardly a frequent long-term problem.Thus, we conclude that both procedures are equally effective for treatment of pancreatic cancer.SUMMARY AND CONCLUSIONPreservation of the gastric antrum and pylorus during pancteaticoduodenectomy represents one of the recent advances in pancreatic surgery and is on example of the modern surgical proposal to respect human physiology as much as possible.This study was conducted in general surgery department, Zagazig university hospital between September 2004 and December 2005 on 23 patients presented with pancreatic cancer. 12 patients (52.2%) underwent PPPD and 11 patients (47.8 %) the Whipple procedure.In this study, there were no significant differences in the age, sex, tumor localization and staging between both groups.There was no significant difference between PPPD and the Whipple operation in terms of operating time, blood loss, hospital stay and blood transfusion. Both PPPD and the Whipple procedure were associated with a low mortality rate and few major operative complications. PPPD was associated with more frequent delayed gastric emptying, although more patients are needed to demonstrate this conclusively.Pylorus-preserving pancreaticoduodenectomy has operative mortality and morbidity rates more or less similar to those seen with the standard Whipple resection and does not impair radicality in the treatment of pancreatic cancer. It probably offers long-term digestive function in patients with pancreatic cancer that was reflected by better nutritional results.We conclude that PPPD represents an important advance in the history of pancreatic surgery. the operation has comparable results with the standard Whipple resection. Although delayed gastric emptying may be more frequently seen with PPPD, this complication is easily managed, and is hardly a frequent long-term problem.Thus, we conclude that both procedures are equally effective for treatment of pancreatic cancer.SUMMARY AND CONCLUSIONPreservation of the gastric antrum and pylorus during pancteaticoduodenectomy represents one of the recent advances in pancreatic surgery and is on example of the modern surgical proposal to respect human physiology as much as possible.A statistically significant association was found between age and nature of injury, i.e. tendency for homicide in advanced age and unintentional shooting in younger age. Also a statistically significant association was found between the relativity of the assailant and the victim and the nature of injury. i.e., tendancy for unintentional shooting in relatives.A statistically significant association between the nature of injury and distance of firing, i.e. tendency for near or even contact firing in suicide. Also the anatomical site of injury was significantly associated with cause of death. i.e. skull injury lead to death due to brain haemorrhage while other sites of injury lead to death due to internal organs lacerations and haemorrhage and sepsis.As regard the results of serum creatinine and serum uric acid, their mean values were 1.87 mg/dl and 5.74 mg/dl respectively in firearm cases. These mean values were significantly higher than controls (0.39 mg/dl and 3.65 mg/dl respectively). Also we found that serum creatinine and serum uric acid were significantly associated with the time passed since injury to death i.e., the level of serum creatinine and serum uric acid increased as the time progressed.In conclusion serum creatinine and serum uric acid can be used as possible indicators of death due to firearm injury. Moreover their levels may be of help in prediction of the time passed from firearm injury till death.