Pancreaticoduodenectomies in patients without periampullary neoplasms: lesions that masquerade as cancer

Bilirubin levels predict malignancy in patients with obstructive jaundice

“…Preoperative histological confirmation of malignancy is not always possible because of the complex regional anatomy of the pancreaticobiliary system. Endoscopic ultrasound (EUS), direct cholangioscopy and endocystoscopy have increased the probability of obtaining preoperative tissue for analysis, but it is widely recognized by hepatobiliary specialists that, out of concern that a potentially resectable lesion may be missed, patients may undergo resection for suspicious lesions without histological confirmation of cancer 1,2 . Even when the surgeon seeks to obtain intraoperative tissue confirming malignancy prior to proceeding to resection, the patient is exposed to considerable dissection at the time of surgery in order to allow representative tissue samples to be obtained.…”

“…Endoscopic ultrasound (EUS), direct cholangioscopy and endocystoscopy have increased the probability of obtaining preoperative tissue for analysis, but it is widely recognized by hepatobiliary specialists that, out of concern that a potentially resectable lesion may be missed, patients may undergo resection for suspicious lesions without histological confirmation of can-cer. 1,2 Even when the surgeon seeks to obtain intraoperative tissue confirming malignancy prior to proceeding to resection, the patient is exposed to considerable dissection at the time of surgery in order to allow representative tissue samples to be obtained. The decision to proceed to an explorative operation with or without resection is frequently based on accumulated radiological, clinical and biochemical predictors and subsequent discussion at a multidisciplinary team (MDT) meeting.…”

The potential diagnostic value of serum microRNA signature in patients with pancreatic cancer

“…Unfortunately 10% of patients with early stages of PC cannot be detected by CT or other imaging features . Another challenge is that in a subset of patients (∼10%) undergoing pancreaticoduodenectomy due to lesions on CT/US/MRI that mimic cancer, postoperative pathologic review of the tumor mass showed no cancer . Because serum CA 19–9 is not 100% specific and sensitive, other diagnostic serum biomarkers for detection of PC are needed.…”

Cirugía del cáncer de páncreas: estrategias quirúrgicas según los datos basados en la evidencia

“…La consecuencia negativa de la ausencia de diagnó stico histoló gico antes de la cirugía es, por supuesto, el error diagnó stico. En efecto, se estima que entre el 5 y el 10% de los casos con sospecha clínica y radioló gica de malignidad tienen resultados anatomopatoló gicos benignos, y viceversa, hasta el 10% de los pacientes con diagnó stico preoperatorio benigno tendrá un resultado patoló gico positivo para cé lulas malignas [7][8][9][10][11][12] .…”