Arterial encasement on CT does not necessarily indicate arterial invasion. Whenever PC is considered unresectable, endoUS should be used. In patients with controversial CT an EUS data for peripancreatic arteries involvement radical resection might be possible, providing survival benefits as compared to R2- resections or palliative surgery.
Aim. To evaluate information content of confocal laser endomicroscopy with targeted biopsy in verifying etiology of extrahepatic bile duct strictures.Material and methods. There were 28 patients with extrahepatic bile duct strictures who underwent retrograde intervention with confocal laser endomicroscopy and targeted biopsy. Data of confocal laser endomicroscopy and biopsy were compared with final postoperative and histological diagnosis. Follow-up within 1–4 years after endoscopic treatment was also considered.Results. Diagnostic sensitivity, specificity and overall accuracy of the method in differential diagnosis of common bile duct strictures were 91.7%, 93.7% and 92.8%, respectively. Complication (acute edematous pancreatitis) occurred in 1 (3.6%) case.Conclusion. Confocal laser endomicroscopy is new effective method for in vivo microscopic assessment of mucous membrane. Despite technical complexity, the method is not associated with advanced morbidity and, accordingly, has no additional contraindications in comparison with ERCP.
Aim. To evaluate the informational content of endoscopic ultrasound in pediatric patients with pancreatobiliary diseases. Materials and methods. The study included 16 patients with pancreatobiliary diseases, who were examined with 17 endoscopic ultrasounds within 14 months. The follow-up was 12 months. Results. Endoscopic ultrasound was informative in all 16 patients and in 14 patients it had an impact on the management. The main diseases that were indications for the examination included choledocholithiasis, pancreatobiliary abnormalities, relapsing pancreatitis, pancreatic cysts, as well as a combination of these diseases. There were no complications during the diagnostic examination as well as during the procedure done under the control of endoscopic ultrasonography. Conclusion. Endoscopic ultrasound is promising, effective and safe not only in adults but also in pediatric patients.
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