Different Clinical Characteristics Between Distal Cholangiocarcinoma and Pancreatic Head Carcinoma With Biliary Obstruction

Different Clinical Characteristics Between Distal Cholangiocarcinoma and Pancreatic Head... Objectives The aim of this study was to compare the perioperative clinical characteristics between patients with distal cholangiocarcinoma (DCC) and pancreatic head carcinoma (PHC) with biliary obstruction. Methods This study included patients who underwent pancreatoduodenectomy and were diagnosed with DCC (n = 85) or PHC (n = 90) by final pathological examination. Perioperative clinical characteristics were compared for patients with DCC versus PHC with biliary obstruction. Results Median coronal thickness of the pancreatic neck was significantly greater, whereas the main pancreatic duct diameter was significantly smaller in patients with DCC than patients with PHC. Most patients with DCC (95%) had a soft pancreas, whereas only 29% of patients with PHC had. The incidence rates of overall morbidity, infectious complications, and pancreatic fistula were significantly higher in patients with DCC than those in patients with PHC. Eleven DCC patients (12%) were preoperatively misdiagnosed with PHC. Among them, intraductal ultrasonography of the bile duct was performed in 7 patients, and the presence of PHC was suspected in 3 of these patients because intraductal ultrasonography detected a small intrapancreatic mass. Conclusions This study clearly showed different perioperative characteristics between patients with DCC and PHC. It is not uncommon to misdiagnose PHC as DCC. Intraductal ultrasonography may be helpful in differentiating DCC and PHC. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pancreas Wolters Kluwer Health

Different Clinical Characteristics Between Distal Cholangiocarcinoma and Pancreatic Head Carcinoma With Biliary Obstruction

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Publisher
Wolters Kluwer Health
Copyright
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
ISSN
0885-3177
eISSN
1536-4828
D.O.I.
10.1097/MPA.0000000000000942
Publisher site
See Article on Publisher Site

Abstract

Objectives The aim of this study was to compare the perioperative clinical characteristics between patients with distal cholangiocarcinoma (DCC) and pancreatic head carcinoma (PHC) with biliary obstruction. Methods This study included patients who underwent pancreatoduodenectomy and were diagnosed with DCC (n = 85) or PHC (n = 90) by final pathological examination. Perioperative clinical characteristics were compared for patients with DCC versus PHC with biliary obstruction. Results Median coronal thickness of the pancreatic neck was significantly greater, whereas the main pancreatic duct diameter was significantly smaller in patients with DCC than patients with PHC. Most patients with DCC (95%) had a soft pancreas, whereas only 29% of patients with PHC had. The incidence rates of overall morbidity, infectious complications, and pancreatic fistula were significantly higher in patients with DCC than those in patients with PHC. Eleven DCC patients (12%) were preoperatively misdiagnosed with PHC. Among them, intraductal ultrasonography of the bile duct was performed in 7 patients, and the presence of PHC was suspected in 3 of these patients because intraductal ultrasonography detected a small intrapancreatic mass. Conclusions This study clearly showed different perioperative characteristics between patients with DCC and PHC. It is not uncommon to misdiagnose PHC as DCC. Intraductal ultrasonography may be helpful in differentiating DCC and PHC.

Journal

PancreasWolters Kluwer Health

Published: Mar 1, 2017

References

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