Endoscopic ultrasonography in the differential diagnosis of biliopancreatoduodenal tumors

Abstract

Objective . Todeterminethe role ofendoscopicultrasonography in preoperative differentialdiagnosis of bilio pancreatoduodenal tumorsand choice of further treatment strategy. Material and methods . A retrospective analysis included medical records of 89 patients hospital-ized with suspected biliopancreatoduodenal tumor.Pancreatic head tumor was diagnosed in 41(46.1%) patients, tumorof major duodenal papilla – in 15 patients (16.9%), tumor of distal seg-ment of common bile duct – in 10 patients (11.2%), cicatricial and inflammatory strictures of distal segment of common bile duct – in 19 patients (21.3%), post-necroticpseudocysts of pancreatic head – in 4 patients (4.5%). Results . Sensitivity ofendoscopic ultrasonography for tumors of pancreatic head, major duodenal papilla, distal common bile duct, cicatricial and inflammatory strictures of distal segment of com-mon bile duct and postnecroticpseudocysts of pancreatic head was 90.2%, 100%, 80%, 94.7% and 100%, respectively. Specificity was 97.9%, 94.6%, 98.7%, 98.6% and 100%, respectively. Overall accuracy was 94.4%, 95.5%, 96.6%, 97.8% and 100%, respectively. False-negative results were obtained in 7 cases. Tumor was not excluded in these patients, but there was a conclusion about an-other primary source of growth. Conclusion . Endoscopic ultrasonography is associated with high accuracy of preoperative differen-tial diagnosis of malignant and benign biliopancreatoduodenaltumors and useful to clarify diagnosis in patients with mechanical jaundice syndrome. These data are usedas an objective criterion to de-termine further treatment strategy depending on the results of endoscopic ultrasonography.