Surgical endoscopy · 1998
Pancreatic carcinoma. Diagnostic and prognostic implications of a normal pancreatogram.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Hewitt P M, Beningfield S J, Bornman P C, Krige J E, van Wyk M E, Terblanche J
Аннотация
BACKGROUND: The aim of this study was to establish the implications of a normal pancreatogram in patients with pancreatic cancer.
METHODS: We reviewed all ERCP done at our institution for the period 1983-92 and studied 62 of 727 patients who had a diagnosis of pancreatic (n = 416) or biliary (n = 311) cancer but a normal pancreatic duct.
RESULTS: Thirty of the 62 patients had pancreatic cancer. In 15 cases, the ERCP diagnosis was incorrect, and in 19 cases, Santorini's duct was not visualized. Other imaging revealed a pancreatic head mass in 25 patients (2.5->7 cm). Only three patients had resectable tumors; another eight underwent laparotomy. Five had bypass surgery, 10 required biliary stenting, and nine had no treatment. Four patients died in hospital, and eight were lost to follow-up. In the remaining 18 patients, median survival was 7 months (range, 1-30 months).
CONCLUSION: A normal pancreatogram does not exclude the diagnosis of pancreatic cancer, nor does it confer a better prognosis.
METHODS: We reviewed all ERCP done at our institution for the period 1983-92 and studied 62 of 727 patients who had a diagnosis of pancreatic (n = 416) or biliary (n = 311) cancer but a normal pancreatic duct.
RESULTS: Thirty of the 62 patients had pancreatic cancer. In 15 cases, the ERCP diagnosis was incorrect, and in 19 cases, Santorini's duct was not visualized. Other imaging revealed a pancreatic head mass in 25 patients (2.5->7 cm). Only three patients had resectable tumors; another eight underwent laparotomy. Five had bypass surgery, 10 required biliary stenting, and nine had no treatment. Four patients died in hospital, and eight were lost to follow-up. In the remaining 18 patients, median survival was 7 months (range, 1-30 months).
CONCLUSION: A normal pancreatogram does not exclude the diagnosis of pancreatic cancer, nor does it confer a better prognosis.