Preoperative Prediction of The Operability of Pancreatic Carcinoma

Abstract

This work discussed the best diagnostic modility for early detection of pancreatic cancer compared to final diagnosis reached by histopathological examination. The present study was constructed by doing imaging modalities computed tomography (CT) and endoscopic ultrasonography (EUS) on 24 patients admitted to surgery department in the faculty of medicine with suspected pancreatic malignancy. As regard masses diameters detected by each modality, EUS was found to be superior to CT in detection of masses less than 20mm in diameter. According to the mass nature, those found in the head region tended to be malignant more frequently than the body and tail, Moreover, solid heterogeneous masses also were more likely to be malignant than the cystic ones as detected by the imaging modalities, with higher accuracy of EUS than with CT. EUS showed more accurate information as regards lymph node involvement and vascular invasion than CT. All of which affected the assessment of resectability of pancreatic masses. On head-to-head comparison, EUS appeared to perform better than CT scan in respect to nodal staging. Based on these results, we conclude that EUS staging should be the standard of care along with state of the art CT scan for the preoperative evaluation of patients with pancreatic cancer. However, large, prospective, multicenter studies directly comparing the accuracy of linear EUS vs. new generation CT scanners are still needed.