Summary
Pancreatograms obtained in 65 patients — undergone ERCP for suspected chronic pancreatic disease and subsequent pancreatic surgery — were compared with histopathological features in order to verify the ERP usefulness in the differential diagnosis between chronic pancreatitis and pancreatic cancer. Accordance between radiological and surgical diagnosis failed to be achieved in 4 cases, because of the overlap between lesions in advanced chronic pancreatitis and pancreatic cancer.
Reexamination of radiological findings of the 4 patients showed that the morphology of the post-obstructive part of the main pancreatic duct was useful for differential diagnosis. Therefore, in order to further improve the diagnostic value of ERCP, the importance of that morphological parameter should be pointed out.
Résumé
Les pancréatogrammes obtenus chez 65 patients soumis à une pancréatographie rétrograde pour suspicion d'affection pancréatique chronique et opération chirurgicale ultérieure, ont été comparés aux données histopathologiques afin de vérifier l'utilité de la méthode d'opacification dans le diagnostic différentiel entre pancréatite chronique et cancer du pancréas. Une absence de concordance entre les diagnostics radiologique et chirurgical a été relevée dans 4 cas en raison d'une interférence entre les lésions dans les pancréatites chroniques évoluées et le cancer pancréatique.
La réévaluation des données radiologiques des 4 patients a montré la contribution au diagnostic différentiel des données de la morphologie pancréatique en amont de l'obstruction sur le canal de wirsung. L'importance de cette donnée morphologique est soulignée dans une perspective d'amélioration du diagnostic discriminatoire par ERCP.
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Testoni, P.A., Masci, E., Guslandi, M. et al. The role of pancreatography in differential diagnosis between chronic pancreatitis and pancreatic cancer. Acta Endosc 11, 435–441 (1981). https://doi.org/10.1007/BF02970415
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DOI: https://doi.org/10.1007/BF02970415