Abbas, M., Nafeh, A., Farouk, Y., Seyam, M., Atta, Y., Omar, A. (2006). RELIABILITY OF PREDICTION OF PERIAMPULLARY TUMOURS RESECTABILITY BEFORE PANCREATICODUODENECTOMY OPERATION. test, 25(3), 155-162. doi: 10.21608/ejsur.2006.373067
Mohamed Abbas; Ayman Nafeh; Youssef Farouk; Moataz Seyam; Yasser Atta; Ahmed Omar. "RELIABILITY OF PREDICTION OF PERIAMPULLARY TUMOURS RESECTABILITY BEFORE PANCREATICODUODENECTOMY OPERATION". test, 25, 3, 2006, 155-162. doi: 10.21608/ejsur.2006.373067
Abbas, M., Nafeh, A., Farouk, Y., Seyam, M., Atta, Y., Omar, A. (2006). 'RELIABILITY OF PREDICTION OF PERIAMPULLARY TUMOURS RESECTABILITY BEFORE PANCREATICODUODENECTOMY OPERATION', test, 25(3), pp. 155-162. doi: 10.21608/ejsur.2006.373067
Abbas, M., Nafeh, A., Farouk, Y., Seyam, M., Atta, Y., Omar, A. RELIABILITY OF PREDICTION OF PERIAMPULLARY TUMOURS RESECTABILITY BEFORE PANCREATICODUODENECTOMY OPERATION. test, 2006; 25(3): 155-162. doi: 10.21608/ejsur.2006.373067

RELIABILITY OF PREDICTION OF PERIAMPULLARY TUMOURS RESECTABILITY BEFORE PANCREATICODUODENECTOMY OPERATION

The Egyptian Journal of Surgery
Volume 25, Issue 3, July 2006, Pages 155-162    PDF (683.57 K)
Document Type: Original Article
DOI: 10.21608/ejsur.2006.373067
Authors
Mohamed Abbas1; Ayman Nafeh* 1; Youssef Farouk1; Moataz Seyam2; Yasser Atta3; Ahmed Omar4
1Departments of General Surgery, Kaser El Aini Faculty of Medicine, Cairo University, Egypt
2Tropical Medicine and 3 Radiology, Kaser El Aini Faculty of Medicine, Cairo University, Egypt
3Radiology, Kaser El Aini Faculty of Medicine, Cairo University, Egypt
4Theodor Bilharz Research Institute and Department of Surgery, Kaser El Aini Faculty of Medicine, Cairo University, Egypt
Abstract
Aim: The aim of this study was to evaluate the accuracy of preoperative assessment in predicting surgical resectability in 
cases with periampullary tumours in reference to the intraoperative findings. 
Methods: This study included 88 cases with obstructive jaundice suspected to have potentially resectable periampullary 
tumours and fit for surgical exploration. These cases were subjected to biochemical laboratory investigations, 
ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), computerized tomography (CT) scan, and diagnostic laparoscopy before surgical exploration. 
Results: Surgical exploration revealed that 59 (67%) cases were irresectable due to portal vein(39) and coeliac trunk(5)
invasions, LN infiltration,(2) liver metastasis(7) peritoneal nodules(3) and peripancreatic fat affection.(3) Abdominal US and ERCP were of little value in predicting resectability of such tumours. CT gave sensitivity and specificity in portal vein (97.4% & 100%) and coeliac trunk (100% & 100%) invasion, liver metastasis (71.4% & 100%) and peritoneal nodules (33.3% & 100%) respectively. Diagnostic laparoscopy could detect cases of small lesions of peritoneal nodules and liver metastasis that were missed on CT scanning. Although the sensitivity of detection of LN and peripancreatic fat plane affection were 100 %, their specificity were much less reliable that reached 75% & 60 % respectively. 
Conclusion: CT revealed high accuracy results in evaluation of periampullary tumours resectability before 
pancreaticoduodenectomy operations. Its accuracy is improved on using diagnostic laparoscopy before exploratory 
laparotomy to detect early metastasis.
Keywords
Pancreatic resection; Preoperative assessment; Operability
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