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GGT is expressed on the luminal surface of excretive and absorptive cells that line glands and ducts throughout the body, with the highest level of GGT activity in the kidney and pancreas ducts [28]

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With the recognition of the importance of the fundamental technical steps of the procedure, such as sac dissection and excision, that were not performed at the time of the original Boerema procedure, this technique has been modified and proposed again