Endoscopic ultrasonography in the differential diagnosis of pancreatic cystic lesions

Written by Solodinina E.N., Starkov Yu.G., Zamolodchikov R.D., Solodinin P.A.

  UDK: 616.37-006-073.756.8-073.432.1 | Pages:  71–76 | Full text PDF | Open PDF 


Background. The differential diagnosis of pancreatic cystic lesions is still the most debatable issue in abdominal surgery. Among the cystic tumors the non-tumor lesions are often encountered in this region. Endoscopic ultrasonography is becoming of more importance in terms of diagnosis, treatment strategy and cure of patients with pancreatic cystic lesions. The aim of this study is to define diagnostic criteria and evaluate significance of the endoscopic ultrasonography in the differential diagnosis of pancreatic cystic lesions.
Methods. 125 patients with pancreatic cystic lesions underwent the examination, including endoscopic ultrasonography, abdominal ultrasosonography, computed tomography, magnetic resonance imaging. A comparative analysis of efficiency of these methods was performed.
Results. The sensitivity of the endoscopic ultrasonography is 91,4 %, specificity is 95,4 %, accuracy is 93,5 %. The efficiency of the endoscopic ultrasonography exceed other diagnostic
methods. The main criteria in the differential diagnosis of pancreatic cystic lesions were defined.
Conclusions. The endoscopic ultrasonography should be use for complex evaluation of patients with pancreatic cystic lesions in multi-disciplinary surgical hospitals.

Links to authors:
E.N. Solodinina1, Yu.G. Starkov1, R.D. Zamolodchikov1, P.A. Solodinin2
1 A.V. Vishnevsky Institute of Surgery (27 Bolshaya Serpuhovskaya St. Moscow 115093 Russian Federation,
2 Moscow Research and Practical Centre for Narcology (37/1 Lublinskaya St. Moscow 109930 Russian Federation)

1. Karmazanovskiy G.G., Guzeeva E.B., Shipuleva I.V. Spiral computed tomography in diseases of hepatopancreatoduodenal zone // Annals of Surgical Hepatology. 1998. Vol. 3, No. 2. P. 15–23.
2. Azar C., Van de Stadt J., Rickaert F. [et al.]. Intraductal papillary mucinous tumours of the pancreas. Clinical and therapeutic issues in 32 patients // Gut. 1996. Vol. 39. P. 457–464.
3. Bassi C., Salvia R., Gumbs A.A. [et al.]. The value of standard serum tumor markers in differentiating mucinous from serous cystic tumors of the pancreas: CEA, Ca 19-9, Ca 125, Ca 15-3 // Langenbecks Arch. Surg. 2002. Vol. 387. P. 281–285.
4. Bassi C., Salvia R., Molinari E. [et al.]. Management of 100 consecutive cases of pancreatic serous cystadenoma: wait for symptoms and see at imaging or vice versa? // World J. Surg. 2003. Vol. 27. P. 319–323.
5. Goh B.K., Tan Y.M., Chung Y.F. [et al.]. Non-neoplastic cystic and cystic-like lesions of the pancreas: May mimic pancreatic cystic neoplasms // ANZ J. Surg. 2006. Vol. 76. P. 325–331.
6. Goldsmith J.D. Cystic neoplasms of the pancreas // Am. J. Clin. Pathol. 2003. Vol. 119. P. S3–S16.
7. Hutchins G.F., Draganov P.V. Cystic neoplasms of the pancreas: a diagnostic challenge // World J. Gastroenterol. 2009. Vol. 15, No. 1. P. 48–54.
8. Jacobson B.C., Baron T.H., Adler D.G. [et al.]. ASGE guideline: The role of endoscopy in the diagnosis and management of cystic lesions and inflammatory fluid collection of the pancreas // Gastroointest. Endosc. 2005. Vol. 61, No. 3. P. 363–370.
9. Kosmahl M., Pauser U., Peters K. [et al.]. Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal // Virchows Arch. 2004. Vol. 445. P. 168–178.
10. Oh H.C., Kim M.H., Hwang C.Y. [et al.]. Cystic lesions of the pancreas: challenging issues in clinical practice // Am. J. Gastroenterol. 2008. Vol. 103. P. 229–239;
11. Sahani D., Prasad S., Saini S., Mueller P. Cystic pancreatic neoplasms evaluation by CT and magnetic resonance cholangiopancreatography // Gastrointest. Endosc. Clin. N. Am. 2002. Vol. 12. P. 657–672.
12. Seicean A., Tantau M., Badea R., Spârchez Z. The applicability of radial endoscopic ultrasonography in pancreatic diseases // J. Gastrointestin. Liver Dis. 2007. Vol. 16, No. 1. P. 77–83.
13. Spinelli K.S., Fromwiller T.E., Daniel R.A. [et al.]. Cystic pancreatic neoplasms: observe or operate // Ann. Surg. 2004. Vol. 239. P. 651–657.
14. Visser B.C., Muthusamy V.R., Yeh B.M. [et al.]. Diagnostic evaluation of cystic pancreatic lesions // HPB. 2008. Vol. 10. P. 63–69.
15. Yamao K., Nakamura T., Suzuki T. [et al.]. Endoscopic diagnosis and staging of mucinous cystic neoplasms and intraductal papillary-mucinous tumors // J. Hepatobiliary Pancreat. Surg. 2003. Vol. 10. P. 142–146.


Founded in 1997  |  Editions in a year: 4, Articles in one issue: 30 |  ISSN of print version: 1609-1175  |  Ind.: 18410 (Agency "Rospechat’")  |  Edition: 1000 c.