The Value of Endoscopic Ultrasonography in Predicting Resectability and Margins of Resection for Periampullary Tumors
Cure of pancreatic head and other periampullary neoplasms continues to be infrequent and is unattainable unless clear surgical margins are achieved during Whipple pancreaticoduodenectomy. Endoscopic ultrasonography (EUS) is a relatively recent gastrointestinal tumor imaging modality and may be superior to other techniques used in locoregional staging. We hypothesized that EUS can accurately predict not only tumor resectability, but also negative resection margins with Whipple resection. A retrospective review was undertaken of 81 consecutive patients with periampullary tumors who underwent preoperative CT and EUS followed by surgical exploration for intended Whipple resection. Correlations among preoperative EUS results, successful resection, and surgical margins on final histopathology were investigated. Of the 81 patients, 61 (75%) underwent successful Whipple resection, and 20 (25%) were found to be unresectable at laparotomy. Resection was achieved in 57 (86%) of 66 patients predicted to be resectable by EUS. Of the 61 resected patients, 52 (85%) had negative margins and nine (15%) had positive margins on final pathology. Margins were determined to be negative in 50 (88%) of 57 resected patients predicted to have negative margins by EUS. We conclude that EUS is a powerful and desirable imaging modality in the preoperative assessment of periampullary neoplasms.
No Reference information available - sign in for access.
No Citation information available - sign in for access.
No Supplementary Data.
No Article Media
Document Type: Research Article
Affiliations: From Harbor–UCLA Medical Center, Torrance, California
Publication date: 01 October 2008
More about this publication?
- The Southeastern Surgical Congress owns and publishes The American Surgeon monthly. It is the official journal of the Congress and the Southern California Chapter of the American College of Surgeons, which all members receive each month. The journal brings up to date clinical advances in surgical knowledge in a popular reference format. In addition to publishing papers presented at the annual meetings of the associated organizations, the journal publishes selected unsolicited manuscripts. If you have a manuscript you'd like to see published in The American Surgeon select "Information for Authors" from the Related Information options below. A Copyright Release Form must accompany all manuscripts submitted.
- Information for Authors
- Submit a Paper
- Subscribe to this Title
- Membership Information
- Annual Scientific Meeting
- Ingenta Connect is not responsible for the content or availability of external websites