Key words: Ampulla of Vater. Signet ring cell. Adenocarcinoma. Palabras clave: Ampolla de Vater. Células en anillo de sello. Adenocarcinoma. Download full text in PDFDownload Le lesioni tumorali benigne dell'ampolla di Vater e le lesioni pseudotumorali (adenomiomi e duodenale o al pancreas e/o linfonodale in endoscopia e l'assenza di un carcinoma invasivo sulla biopsia. L 'ampullectomia chirurgica, guidata da un esame istologico estemporaneo. El cáncer ampular, cáncer de la ámpula de Vater o carcinoma del ámpula de Vater, es una . Crear un libro · Descargar como PDF · Versión para imprimir.
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Total downloads: Downloads last week: 83 Cancer De Ampolla De Vater for Mac works well to add cover art displays for the. Article (PDF Available) in HPB Surgery (3) · March with Reads Download full-text PDF. Other full-text sources. Content . Carcinoma adenoneuroendocrino mixto de la ampolla de Vater: reporte de caso. Article. PDF | Two patients with mucosal cancer of the periampullary region were treated Download full-text PDF .. Cancer de la ampolla de Vater.
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Cases with combined abnormal findings in the body and tail were 5. Thus, more than half of the cases had abnormal findings in the head portion Table 3.
This was followed in frequency by Type III pancreatic duct dilatation 3. Abnormal Findings in Bile Ducts Common bile ducts were visualized in 55 of the cases with pancreatic cancer Table 2.
Of those 55 cases, common bile ducts were normal in 17, and abnormal in The abnormal findings were indentation Cases with abnormal findings in the proximal common bile duct comprised 3. There was 1 case of cancer in the tail portion, in which there was supposed to have been an abnormal common bile duct finding from metastatic lesion.
Although recently, ERCP, ultrasonography US , and computed tomography CT have been widely used for the diagnosis of pancreatic cancer, early diagnosis is still difficult. The prognosis of pancreatic cancer is very poor because the retroperitoneal location of the cancer is unsuitable for direct palpation, the proximity of the portal vein, hepatic, and superior mesenteric arteries may preclude removal, depending on the location of the tumor even in its early stage, and the profuse lymphatics and venous drainage of the pancreas invite early and widespread dissemination of the tumor cells.
Gudjonssen et al, reported that the absolute 5 years survival rate calculated from 61 clinical studies representing 15, patients is 0. ERCP, especially, with the rapid development of fiberoptic duodenoscopes and special techniques, has made it possible to evaluate the diseases of pancreatic and biliary ducts by visualization of the duodenum and ampulla of Vater, direct cannulation for the injection of contrast material into both pancreatic and biliary ducts for radiographic visualization, and by the obtaining of pure pancreatic juice for cytology and chemical analysis.
Of the 8 cases with nonvisualized pancreatic ducts, 7 were diagnosed by surgery and other methods as having pancreatic cancer. Therefore, in these cases nonvisualization of the pancreatic duct had diagnostic significance in itself. Thus, the failure rate of visualization of the pancreatic duct was 3.
Cotton et al. Freeny et al. Fitzgerald et al. In our study, of the cases of pancreatic cancer were diagnosed by the findings of pancreatic ducts showing a diagnostic accuracy of Seven of the 8 cases with nonvisualized pancreatic ducts were diagnosed as having pancreatic cancer by surgery and other methods. In these cases the fact that the pancreatic ducts were not visualized had diagnostic significance in itself, thus the diagnostic accuracy was Of the cases with visualized pancreatic ducts, cases showed abnormal findings and 4 cases of normal pancreatic ducts which were proved to contain carcinoma in the tail 2 cases and in an uncinate process 2 cases.
Thus findings, the diagnostic accuracy of ERCP in pancreatic cancer was Malagelad et al. The diagnostic accuracy of CT for pancreatic cancer, was reported to be from Gudjonsson et al.
Fukumoto et al, reported the head in 25 cases, the body and tail in 16 cases, and diffuse in 4 cases in 45 cases and Choi et al. In our study, the head was the most common Levison explained that the head portion was the most frequent site of pancreatic carcinoma and surgical exploration of head portion for cancer was more commonly done than cancer of the other portions of the pancreas because pancreatic head cancer was manifested earlier due to jaundice.
Silvis et al. Rhormann et al.
They classified the pancreatic duct termination into 6 types: 1 blunt, 2 nonspecific or HI-defined, 3 tapered, 4 meniscus, 5 eccentric, irregular of destructive, and 6 square. He reported that 11 cases were diagnosed correctly by ERCP, and irregular or rat-tailed pancreatic duct obstruction was found in 8 cases, pancreatic duct encasement nodular, and eccentirc narrowing in 3 cases, and common bile duct obstruction or encasement in 6 cases.
They have formulated some working hypotheses that 1 unless ERCP findings satisfy the criteria of pancreatic carcinoma described above, it must be inadequate, 2 if one major duct shows equivocal findings of carcinoma, it is essential to visualize the adjacent ducts if carcinoma involving that duct is to be excluded, 3 if one major duct shows equivocal findings of carcinoma and the adjacent ducts are normal, the disease involving that duct is probably benign, and 4 if a duct shows unequivocal findings of carcinoma, even in the midst of ducts involved with benign disease, that duct is considered to be involved by carcinoma until proven otherwise.
The findings of the main pancreatic duct were obstruction in 15 cases, encasement in 1 case, field acinar defect in 1 case, excavated cavity in 1 case, and normal in 3 cases common bileduct encased. The findings on the common bile duct were obstruction in 1 case, encasement in 8 cases, and normal in 2 cases. They also suggested that the differential diagnosis of an obstructed pancreatic duct included incomplete filling, pancreatitis, neoplasm, and trauma.
Incomplete filling is distinguished from other obstruction by incomplete side branch filling and a subtle fading or feathering of the ductal terminus. Chronic pancreatitis may lead to ductal obstruction by fibrosis, intraductal calculi, abscess or pseudocyst, and proximal to the obstruction, the main duct and secondary side branch usually show characteristic changes of chronic pancreatitis: ectasia, beading, multiple focal stenosis, marginal irregularities and calculi.
However, Ralls et al.