Is a preoperative multidiagnostic approach to predict surgical resectability of periampullary tumors still effective?

Schwarz, Michael; Pauls, Sandra; Sokiranski, Roman; Brambs, Hans‐Jürgen; Glasbrenner, B.; Adler, Guido; Diederichs, C. G.; Reske, Sven N.; Möller, Peter; Beger, Hans G.

doi:10.1016/s0002-9610(01)00707-3

Cited by 71 publications

(46 citation statements)

References 23 publications

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“…Twenty-two papers (10%) matched the selection criteria while the remainder (197, 90%) were excluded [2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] . Seventeen articles were prospective [2,[4][5][6][9][10][11][12][13][14][15]18,[20][21][22][23][24] and five retrospective [7,8,16,17,19] . In all studies radiological findings where compared with both intraoperative findings and final histopathological analysis that were considered gold-standards of comparison.…”

Section: Resultsmentioning

confidence: 99%

“…The sensitivity of EUS for diagnosing the primary tumour has been reported in thirteen studies (Table 2) [4,6,7,[9][10][11][12][13]15,16,18,19,22] and the range varied between 92% and 100% [9,10,15,16,22] . The overall sensitivity estimated by the sum of the total true positives / total number of patients was 97% (474/488) (Table 6) [4,6,7,[9][10][11][12][13]15,16,18,19,22] .…”

Section: Tumour Diagnosis: Eusmentioning

confidence: 97%

“…Rivadeneira DE [16] Midwinter MJ [13] Shoup M [19] Maluf-Filho F [11] Cannon ME [5] Mukai H [15] Mukai H [15] Schwarz M [18] Skordilis P [20] Mansfield SD [12] Chen CH [6] Tomazic A [21] Chen CH [7] Brugge WR [4] Ho JM [8] Howard TJ [9] Tio TL [2] Zhang QL [23] Zhang QL [23] Rosch T [17] Mitake M [14] Kubo H [10] Yasuda K [22] Tierney WM [24] Recruitment period 1996-2000 1996-1998 1996-1998 1997-1999 1994-1997 1984-1991 1984-1991 1996-1997 1993-2000 2002-2004 1996-1999 -1998-2006 1996-2007 1993-1996 1987-1988 1989-1992 1989-1992 1991-1995 1985-1988 1988-1997 1982-1987 1996-1999 Type of study [15] and Zhang [23] present results for ampullary cancers and common bile duct cancers separated, for this reason they are reported in two separated rows each. Table 2 Tumour detection rate.…”

Section: Studymentioning

confidence: 99%

“…Yasuda K [22] Mukai H (Ampullary) [15] Mukai H (CBD) [15] Tio TL [2] Kubo H [10] Zhang QL (Ampullary [23] Zhang QL (CBD) [23] Brugge WR [4] Howard TJ [9] Skordilis P [20] Cannon ME [5] Schwarz M [18] Midwinter MJ [13] Shoup M [19] Chen CH [6] Rivadeneira DE [16] Maluf-Filho F [11] Chen CH [7] Mansfield SD [12] Yasuda K [22] Mukai H (Ampullary) [15] Mukai H (CBD) [15] Brugge WR [4] Howard T [9] Schwarz M [18] Midwinter MJ [13] Shoup M [19] Chen CH (2001) [6] Rivadeneira DE [16] Maluf-Filho F [11] Chen CH [7] Mansfield SD [12] Imaging …”

Section: Studymentioning

confidence: 99%

“…The overall sensitivity estimated by the sum of the total true positives / total number of patients was 97% (474/488) (Table 6) [4,6,7,[9][10][11][12][13]15,16,18,19,22] . Specificity was reported by five studies with a range from 33 to 93% (Table 2) [11,12,16,18,19] . Of these, the highest value (93%) came from the largest series (103 patients) [18] , and the lowest value (33%) from the smallest series (37 patients) [19] .…”

Section: Tumour Diagnosis: Eusmentioning

confidence: 99%

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The Difference Between EUS & CT Scan in Diagnosing and Staging Peri Ampullary Tumours: An evidence-based approach

Saad

Gravante

Andrew

et al. 2015

Journal of Gastroenterology and Hepatology Research

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Periampullary carcinoma has a better prognosis than pancreatic adenocarcinoma. Hence accurate pre -operative staging is essential for avoiding surgical exploration for unresectable tumours. At the same time, operable cases should not be denied curative surgery based on false positive imaging. Hence it is essential that the imaging should have a high positive predictive value. This article makes a case for the utility of EUS in the accurate diagnosis of periampullary cancer, the detection of lymph node metastases and invasion of the Portal/Superior Mesenteric vein as compared to CT scanning. Electronic search of the PubMed, Embase and Cochrane Central Register of Controlled Trials databases was performed from 1982 to May 2009 to identify relevant studies. Articles meeting the criteria were retrieved and studied according to a standard proforma. Data were extracted from the articles into an Excel database and compared. The search revealed 211 published articles. Twenty-one papers matched the selection criteria. Sixteen articles were prospective and five retrospective. The data compared included local staging of the tumour, lymph node and venous involvement. CT scanning remains the initial investigation of choice in the diagnosis and staging of periampullary tumours but EUS might be superior for overall detection of lesions, especially those smaller than 2 cm. Although CT remains the investigation of choice, it is essential that EUS is performed by experienced operators and used when the clinical suspicion is high and CT fails to demonstrate a mass. This could increase the number of early lesions detected and improve the overall prognosis.

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