Central Surgical AssociationOutcomes after preoperative endoscopic ultrasonography and biopsy in patients undergoing distal pancreatectomy
Section snippets
Patients
Between January 2002 and May 2009, 434 consecutive patients underwent distal pancreatectomy at Indiana University Hospital in Indianapolis, IN. We excluded patients who underwent distal pancreatectomy for acute or chronic pancreatitis, those with previous pancreatic resections, and those with metastatic neoplasms. Permission for studying these patients was obtained from the Indiana University School of Medicine Institutional Review and Privacy Board according to the institutional policy for
Patient, disease, and treatment differences
Distal pancreatectomy was performed in 230 patients with primary solid and cystic neoplams of the pancreas. The median age for all patients was 60 years (range, 19–86 years). The most common neoplasm was adenocarcinoma (n = 63; 27%), followed by cystic neoplasm (n = 61; 26%), intraductal papillary mucinous neoplasm (IPMN; n = 45; 20%), and endocrine neoplasm (n = 39; 17%). Cystic neoplasms included 20 serous cystadenomas and 41 mucinous cystadenomas. Fifty-one patients (22%) were in the EUS−
Discussion
Beyond the context of clinical trials investigating tumor effects of novel therapies, the clinical value of preoperative tissue sampling before operative resection of primary pancreatic neoplasms has been questioned.17, 18, 19 Although preoperative EUS-guided biopsy has a high specificity and can preclude operative therapy for some patients with benign solid or cystic pancreatic neoplasms, the diagnostic accuracy of EUS-guided FNA is dependent on several factors, including experience of the
References (32)
- et al.
Predicting resectability of periampullary cancer with three-dimensional computed tomography
J Gastrointest Surg
(2004) - et al.
MR imaging of the pancreas
Magn Reson Imaging Clin N Am
(2005) - et al.
Screening for early pancreatic neoplasia in high-risk individuals: a prospective controlled study
Clin Gastroenterol Hepatol
(2006) - et al.
Screening for pancreatic neoplasia in high-risk individuals: an EUS-based approach
Clin Gastroenterol Hepatol
(2004) - et al.
Preoperative assessment of pancreatic tumors using magnetic resonance imaging, endoscopic ultrasonography, positron emission tomography and laparoscopy
Pancreatology
(2005) - et al.
Comparison of endoscopic ultrasound and computed tomography for the preoperative evaluation of pancreatic cancer: a systematic review
Clin Gastroenterol Hepatol
(2006) - et al.
Assessment of EUS for diagnosing, staging, and determining resectability of pancreatic cancer: a review
Gastrointest Endosc
(2002) - et al.
Robotic distal pancreatectomy: cost effective?
Surgery
(2010) - et al.
Optimal number of EUS-guided fine needle passes needed to obtain a correct diagnosis
Gastrointest Endosc
(2004) - et al.
Postoperative pancreatic fistula: an international study group (ISGPF) definition
Surgery
(2005)