TY - JOUR
T1 - Pancreaticoduodenectomies in patients without periampullary neoplasms
T2 - lesions that masquerade as cancer
AU - Hurtuk, Michael G.
AU - Shoup, Margo
AU - Oshima, Kiyoko
AU - Yong, Sherri
AU - Aranha, Gerard V.
PY - 2010/3/1
Y1 - 2010/3/1
N2 - Background: Most pancreaticoduodenectomies (PDs) are performed to treat periampullary malignancies (PMs). Final pathologic analysis on these specimens does not always contain PMs. Our aim was to classify diseases that preoperatively mimic PMs. Methods: A prospective database of PDs performed at a single institution was reviewed. Clinicopathologic data on patients without PM on pathologic review with preoperative suspicion of PM were studied. Results: Of the 461 PDs performed at our institution, 45 (10%) had no PM; of these cases, 35 (78%) were performed for a clinical suspicion of malignancy. The final pathologic review showed chronic pancreatitis (CP) in 23 (66%) patients, biliary tract disease in 10 (28%) patients, duodenal ulcer in 1 (3%) patient, and distal common bile duct stricture with localized pancreatic fibrosis in 1 (3%) patient. Conclusion: Most patients undergoing PD have evidence of a PM. A subset of patients may have lesions that mimic a PM. In these patients, when PM cannot be ruled out, if possible, they should be offered PD.
AB - Background: Most pancreaticoduodenectomies (PDs) are performed to treat periampullary malignancies (PMs). Final pathologic analysis on these specimens does not always contain PMs. Our aim was to classify diseases that preoperatively mimic PMs. Methods: A prospective database of PDs performed at a single institution was reviewed. Clinicopathologic data on patients without PM on pathologic review with preoperative suspicion of PM were studied. Results: Of the 461 PDs performed at our institution, 45 (10%) had no PM; of these cases, 35 (78%) were performed for a clinical suspicion of malignancy. The final pathologic review showed chronic pancreatitis (CP) in 23 (66%) patients, biliary tract disease in 10 (28%) patients, duodenal ulcer in 1 (3%) patient, and distal common bile duct stricture with localized pancreatic fibrosis in 1 (3%) patient. Conclusion: Most patients undergoing PD have evidence of a PM. A subset of patients may have lesions that mimic a PM. In these patients, when PM cannot be ruled out, if possible, they should be offered PD.
KW - Benign pancreatic lesions
KW - Pancreaticoduodenectomy
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U2 - 10.1016/j.amjsurg.2009.09.011
DO - 10.1016/j.amjsurg.2009.09.011
M3 - Article
C2 - 20226913
AN - SCOPUS:77649284146
SN - 0002-9610
VL - 199
SP - 372
EP - 376
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 3
ER -
