The influence of endoscopic biliary stents on the accuracy of endoscopic ultrasound for pancreatic head cancer staging
| Autor: | Eugenio Giovannini, A Grillo, R Manta, Lauro Bucchi, Giancarlo Caletti, P Fedeli, Stefania Maltoni, Pietro Fusaroli |
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| Přispěvatelé: | Fusaroli P, Manta R, Fedeli P, Maltoni S, Grillo A, Giovannini E, Bucchi L, Caletti G |
| Rok vydání: | 2007 |
| Předmět: |
Endoscopic ultrasound
Adult Male medicine.medical_specialty Pancreatic disease medicine.medical_treatment Biliary Stenting Endosonography Pancreatic cancer medicine Periampullary cancer ENDOSCOPIC ULTRASOUND Humans Stage (cooking) Aged Neoplasm Staging Aged 80 and over medicine.diagnostic_test business.industry Gastroenterology Stent Reproducibility of Results Middle Aged equipment and supplies medicine.disease people.cause_of_death PANCREATIC CANCER digestive system diseases Pancreatic Neoplasms Biliary tract Female Stents Radiology Bile Ducts business people |
| Zdroj: | Endoscopy. 39(9) |
| ISSN: | 1438-8812 |
| Popis: | BACKGROUND AND STUDY AIMS: Biliary stents have been found to interfere with endoscopic ultrasound (EUS) tumor (T) and nodal (N) staging in patients with periampullary cancer. Our aim was to determine whether this also occurs in patients with pancreatic head cancer. PATIENTS AND METHODS: We studied a consecutive series of patients who were undergoing preoperative EUS for diagnosis and staging of suspected pancreatic cancer, some of whom had biliary stents in situ and some of whom did not. The main end point was the uni- and multivariate association of biliary stenting with T and N mis-staging by EUS. The surgical T and N stages were used as gold standards. RESULTS: A total of 65 patients were identified (19 with biliary stents in situ and 46 without). Surgical stage T4 was found more frequently in patients with stents (53 % vs. 22 %, P = 0.014). The T stage by EUS was correct in 85 % of the patients without biliary stents and in 47 % of the patients with stents. The frequency of mis-staging by EUS was significant only among patients with a biliary stent. The distribution by EUS N stage did not differ significantly from the surgical N-stage distribution in the two groups of patients. According to the multivariate analysis, patients with stents were 6.55 times more likely to be incorrectly T staged (95 % confidence interval [CI] 1.69 - 25.49) and 3.71 times more likely to be incorrectly N staged (95 % CI 1.11 - 12.45) than patients without stents. CONCLUSIONS: The results add support to the recommendation that EUS staging of pancreatic head neoplasms should be performed prior to stent placement. |
| Databáze: | OpenAIRE |
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