[The value of endoscopic ultrasonography in the diagnosis of ampullary carcinoma].

The value of endoscopic ultrasonography (EUS) for diagnosing ampullary carcinoma was assessed in 14 patients. The diagnostic accuracy, the chariacteristics of the images and the preoperative invasion of the carcinoma were studied. The results showed that: (1) The lesions were clearly demonstrated in all cases (100.0%) and the diagnostic accuracy of EUS was 78.6%, which was better than that of transabdominal ultrasonography and CT (P < 0.05), but similar to that of endoscopic retrograde cholangio-pancreatography (ERCP) (P > 0.05). Three patients with pancreatic carcinoma were misdiagnosed as ampullary carcinoma by EUS, because the carcinoma was situated at the head of the pancreas and infiltrated to the duodenal wall. (2) Hyperecho image was obtained in 81.8% of the cases and hypoecho image in 18.2% of the cases. (3) The accuracy of EUS in demonstrating the invasion of the carcinoma into the duodenal wall, common bile duct, pancreatic duct and the head of the pancreas was 83.3%, 66.7%, 50.0% and 33.3% respectively and the lymph node matastasis of the carcinoma was 100.0%.