( ( ( Serious injuries ) ( involving ( ( the head ) ( of ( ( ( the pancreas ) and ) ( the duodenum ) ) ) ) ) ) ( ( may ( ( require ( ( ( ( pancreatoduodenectomy or ) temporary ) defunctioning ) ( of ( ( the duodenum ) ( as ( ( a passage ) ( for ( gastric secretions ) ) ) ) ) ) ) ) ( by ( ( ( ( closing ( the pylorus ) ) ( with ( a ( temporary suture ) ) ) ) and ) ( ( emptying ( the stomach ) ) ( by ( a gastroenterostomy ) ) ) ) ) ) ) . ) )
(ROOT (S (NP (NP (JJ Serious) (NNS injuries)) (PP (VBG involving) (NP (NP (DT the) (NN head)) (PP (IN of) (NP (NP (DT the) (NN pancreas)) (CC and) (NP (DT the) (NN duodenum))))))) (VP (MD may) (VP (VB require) (NP (NP (ADJP (JJ pancreatoduodenectomy) (CC or) (JJ temporary)) (NN defunctioning)) (PP (IN of) (NP (NP (DT the) (NN duodenum)) (PP (IN as) (NP (NP (DT a) (NN passage)) (PP (IN for) (NP (JJ gastric) (NNS secretions)))))))) (PP (IN by) (S (VP (VP (VBG closing) (NP (DT the) (NNS pylorus)) (PP (IN with) (NP (DT a) (JJ temporary) (NN suture)))) (CC and) (VP (VBG emptying) (NP (DT the) (NN stomach)) (PP (IN by) (NP (DT a) (NN gastroenterostomy))))))))) (. .)))
Serious injuries involving the head of the pancreas and the duodenum may require pancreatoduodenectomy or temporary defunctioning of the duodenum as a passage for gastric secretions by closing the pylorus with a temporary suture and emptying the stomach by a gastroenterostomy.
(ROOT (S (NP (JJ Gastric) (NN emptying)) (VP (VBZ is) (VP (VBN regulated) (PP (IN by) (NP (NP (PDT both) (DT the) (NN stomach)) (CC and) (NP (DT the) (NN duodenum)))))) (. .)))