Incidence of benign disease in patients that underwent resection for presumed pancreatic cancer diagnosed by endoscopic ultrasonography (EUS) and fine-needle aspiration (FNA)

Sebastian G. de la Fuente, Eugene P. Ceppa, Srinevas K. Reddy, Bryan M. Clary, Douglas S. Tyler, Theodore N. Pappas

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Introduction: The lack of accurate markers makes preoperative differentiation between pancreatic cancer and non-malignant head lesions clinically challenging. In this study, we investigated the incidence of benign disease in patients that underwent resection for presumed pancreatic cancer diagnosed by EUS and EUS-guided FNA. Methods: Medical records of consecutive patients who underwent pancreaticoduodenectomy at Duke University were reviewed. Demographics, clinicopathologic characteristics, preoperative imaging, EUS, EUS-guided FNA, and postoperative outcomes were analyzed. Results: Seven percent of the total 494 patients studied were found to have benign disease on postoperative pathology. Fifty-nine percent of these patients with benign disease underwent preoperative EUS. EUS was positive for a head mass in 70%, demonstrated enlarged lymph nodes in 27%, and showed signs concerning for vascular invasion in 13%. FNA was suspicious or indeterminate for cancer in 63% of patients. Postoperative complications occurred in 47% and one patient died after surgery. The overall pancreatic leak rate was 15%. Conclusions: Even with aggressive use of preoperative evaluation, there is still a small subset of patients where malignancy cannot be excluded without pancreaticoduodenectomy.

Original languageEnglish (US)
Pages (from-to)1139-1142
Number of pages4
JournalJournal of Gastrointestinal Surgery
Volume14
Issue number7
DOIs
StatePublished - Apr 27 2010

Keywords

  • Cancer
  • Endoscopic ultrasonography
  • Pancreas
  • Pancreaticoduodenectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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