P-P07 The incidence of Malignancy in Patients with Suspected Periampullary Tumours Who Underwent Blind Whipple Resections: A Single Institution Cross Sectional Review at King Hussein Medical Centre, Amman, Jordan

Abstract

Abstract Background In this study, we evaluated the incidence of malignant and benign histopathological findings in patients undergoing blind pancreaticoduedenectomy (PD) for presumed periampullary cancer based on clinical, radiological and endoscopic findings. Methods Medical records of 29 patients who underwent pancreaticoduedenectomy at King Hussein Medical Centre were reviewed. Demographics, clinical presentation, preoperative imaging and postoperative histopathological results were analysed Results The percentage of malignancy was 82.8% and that of a benign lesion was 17.2%.All patients with benign results on final histopathology had chronic pancreatitis (100%), and all of them (100%) had abdominal pain on initial presentation. Out of all patients with periampullary malignancy, 21 (87.5%) had jaundice on initial presentation. The most important radiological correlate of malignancy is dilatation of the common bile duct greater than 6mm. Conclusions The finding of chronic pancreatitis in pancreaticoduedenectomy specimens of patients with suspected periampullary malignancy is justifiable, because none of the differences in clinical presentation or available diagnostic modalities can be reliably used to distinguish between benign versus malignant disease. Moreover, Pancreaticoduedenectomy in these patients offers the best chance for long term survival with acceptable mortality and morbidity.