Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer: Experiences with 54 Cases

Stadelmann, O; Sáfrány, L; Löffler, A; Barna, L; Miederer, S. E.; Papp, John P.; Käufer, C; Sobbe, A

doi:10.1055/s-0028-1098602

Cited by 46 publications

(8 citation statements)

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“…Stadelman et al (83) reported that predominant findings in 42 patients with pancreatic carcinoma examined by ERCP were stenosis, prestenotic dilatation, caliber variation, hold up of contrast medium and ductal displacement in pan creatography, and that in 28 cholangiograms in these patients stenoses were found in one third of the cases in the proximal common bile duct. They classi fied findings of pancreatic carcinoma into four types: a stenosing type, an obstructed type, a tapering type and a cavernous type, and the stenosing type was divided in a form with and without interruption of the contrast medium column.…”

Section: Classification O F the Lesionmentioning

confidence: 99%

“…Pathological changes in chronic pancreatitis were usually diffuse, whereas localized severe changes were observed in carcinoma (41). Stadehnann et al (83) thought that a precise differential diagnosis between pancreatic carcinoma and chronic pancre atitis was not possible but a long stenosis with or without hold-up of the con trast medium spoke in favor of a tumorous process. Trapnell (85) reported that both a uniform dilatation of the duct system, and gap between the head of the dye and the duodenum in pancreatogram may be taken as indicative of the presence of a carcinoma of the head of the pancreas, hence allow an immediate distinction between this condition and chronic relapsing pancreatitis.…”

Section: Diagnosis With Pancreatic Carcinomamentioning

confidence: 99%

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Recent Advances in the Endoscopic Retrograde Cholangiopancreatography

Kasugai

1975

Digestion

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Endoscopic retrograde cholangiopancreatography can become a safe and easy procedure by means of sterilization of the instruments. Administration of antibiotics or chemotherapeutic agents, both systemically and mixed with the contrast material, and measurement and control of the injection pressure of the contrast medium using a manometer are employed to achieve as aseptic an operation as possible. For diagnosis of pancreatic cancer in its early stage, as well as diagnosis of minimal and moderate chronic pancreatitis, opacification should extend into not only the main pancreatic duct, but also branches of the pancreatic duct and fine pancreatic ducts. The procedure is one of the most reliable methods for the detection of diseases of pancreatic and biliary systems, especially for the diagnosis of space-occupying lesions such as malignant tumors, and chronic inflammatory changes of the pancreas, as well as differential diagnosis in jaundiced patients.

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Section: Classification O F the Lesionmentioning

confidence: 99%

Section: Diagnosis With Pancreatic Carcinomamentioning

confidence: 99%

Recent Advances in the Endoscopic Retrograde Cholangiopancreatography

Kasugai

1975

Digestion

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“…The use of miniprobes in the pancreatic and bile ducts may increase diagnostic accuracy even further and would be useful in differentiating cholangiocarcinoma from pancreatic cancer [2]. Despite these advanced techniques for the diagnosis of pancreatic carcinoma, the majority of patients still present late, and the rate of resectability is low [14,17]. A normal pancreatogram in this study did not equate with earlier presentation.…”

Section: Discussionmentioning

confidence: 64%

“…Some authors have stressed the overlapping spectrum of ductal changes in pancreatic cancer and chronic pancreatitis. They have reported lower figures [10,16,17], although serum tumor markers, in particular CA 19-9, can now satisfactorily discriminate between these two conditions [18].…”

Section: Discussionmentioning

confidence: 99%

“…Typical ERCP features of pancreatic carcinoma include irregular obstruction or stenosis of the pancreatic duct with or without common bile duct involvement (the so-called double-duct sign), paucity of side ducts, and extravasation of contrast into necrotic tumor [6,10,16,17]. Occasionally, a normal pancreatogram is obtained in a patient with pancreatic cancer [7,9,[11][12][13]15].…”

Section: Discussionmentioning

confidence: 99%

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Pancreatic carcinoma Diagnostic and prognostic implications of a normal pancreatogram

Hewitt

Beningfield²,

Bornman³

et al. 1998

Surgical Endoscopy

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Prognostic implications of tumor diameter in carcinoma of the head of the pancreas

Nix¹,

Dubbelman²,

Wilson³

et al. 1991

Cancer

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Two hundred twenty patients with a carcinoma in the head of the pancreas were divided into three tumor diameter groups: group 1, 0.5 to 4.4 cm (n = 72); group 2, 4.5 to 6.0 cm (n = 77); and group 3, 6.1 to 15.0 cm (n = 71). For these tumor diameter groups a six-fold eliminatory curability analysis was performed. Of the patients with liver metastases in group 1 the last patient had died at 10 months and in groups 2 and 3 no patients were alive at 18 months after the start of complaints. Patients with extrahepatic metastases did not survive 12 months in group 1, 16 months in group 2, and 25 months in group 3. The 6% actuarial survival rate for inoperable patients was reached in group 1 after 17 months, in group 2 after 36 months, and in group 3 after 27 months after the start of complaints. For groups 1 through 3 in curable, but not curatively operated patients, the respective 0% actuarial survival rate was reached at 24 months, 23 months, and 14 months. The 0% actuarial survival rate in patients with irresectable vessel invasion was reached in group 1 at 33 months, in group 2 at 23 months, and in group 3 at 25 months. The 0% actuarial survival rate in patients with an irresectable tumor was reached at 33 months, 31 months, and 27 months after the start of complaints in groups 1, 2, and 3, respectively. The 0% actuarial survival rate in curatively operated patients was reached in group 3 after 26 months and in group 2 after 29 months. In group 1 25% of the patients were alive at 36 months after the start of complaints. Small tumors were associated with the greatest chance of curative operation and on average had the longest survival. However, small tumors with liver or other metastases carried a worse prognosis than large tumors with liver or other metastases. If tumors were found not to be resectable at the time of operation, the size of the tumor did not appear to affect survival.

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Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer: Experiences with 54 Cases

Cited by 46 publications

References 0 publications

Recent Advances in the Endoscopic Retrograde Cholangiopancreatography

Recent Advances in the Endoscopic Retrograde Cholangiopancreatography

Pancreatic carcinoma Diagnostic and prognostic implications of a normal pancreatogram

Prognostic implications of tumor diameter in carcinoma of the head of the pancreas

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