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Titolo:
The impact of laparoscopy and laparoscopic ultrasound on the management ofpancreatic cystic lesions
Autore:
Schachter, PP; Avni, Y; Gvirz, G; Rosen, A; Czerniak, A;
Indirizzi:
Tel Aviv Univ, Sackler Sch Med, E Wolfson Med Ctr, Dept Surg A, Tel Aviv, Israel Tel Aviv Univ Tel Aviv Israel on Med Ctr, Dept Surg A, Tel Aviv, Israel Tel Aviv Univ, Sackler Sch Med, E Wolfson Med Ctr, Dept Gastroenterol, TelAviv, Israel Tel Aviv Univ Tel Aviv Israel Ctr, Dept Gastroenterol, TelAviv, Israel Tel Aviv Univ, Sackler Sch Med, E Wolfson Med Ctr, Dept Radiol, Tel Aviv, Israel Tel Aviv Univ Tel Aviv Israel on Med Ctr, Dept Radiol, Tel Aviv, Israel
Titolo Testata:
ARCHIVES OF SURGERY
fascicolo: 3, volume: 135, anno: 2000,
pagine: 260 - 264
SICI:
0004-0010(200003)135:3<260:TIOLAL>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARCINOEMBRYONIC ANTIGEN; DIFFERENTIAL-DIAGNOSIS; MUCINOUS CYSTADENOCARCINOMA; FLUID ANALYSIS; TUMORS; PSEUDOCYSTS; NEOPLASMS; CYSTADENOMA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Schachter, PP E Wolfson Med Ctr, Dept Surg A, IL-58100 Holon, Israel E Wolfson Med Ctr Holon Israel IL-58100 8100 Holon, Israel
Citazione:
P.P. Schachter et al., "The impact of laparoscopy and laparoscopic ultrasound on the management ofpancreatic cystic lesions", ARCH SURG, 135(3), 2000, pp. 260-264

Abstract

Hypothesis: Laparoscopic ultrasound examination combined with biopsy of the cystic wall and aspiration of cystic fluid improves differential diagnosis of pancreatic cystic lesions contributing to surgical decision making. Study Design: A prospective evaluation of the impact of laparoscopic ultrasound on surgical decision making in patients, with pancreatic cysts. Setting: A general community hospital; the department of surgery serves asreferral for pancreatic surgery. Patients: During a 36-month period, 15 patients with pancreatic cystic lesions were prospectively evaluated by laparoscopy and laparoscopic ultrasound with ultrasound-guided biopsy of the cystic wall and aspiration of cysticfluid for cytologic study, viscosity, and determination of levels of amylase and tumor markers (carcinoembryonic antigen, dancer antigen 19.9). Results: Laparoscopic ultrasound contributed new, additional data in 8 patients (53%) when compared with compiled imaging data obtained by conventional ultrasound, computed tomography, magnetic resonance imaging, and endoscopic ultrasound A solid cystic component was detected in 6 patients and additional small (<1 cm) cysts in 3 patients. Amylase and tumor marker levels, biopsy of the cystic wall, and cytologic examination had significant impacton surgical decision making in 6 patients. Nine patients underwent resection of the cystic lesion. Three patients diagnosed as having benign cysts had laparoscopy with laparoscopic ultrasound only. Three patients with suspicious lesions refused surgery. Laparoscopic ultrasound predicted correctly the nature of the cyst ill 7 of 9 surgically treated patients (sensitivity, 78%). Two patients with serous cystadenoma had high levels of tumor markers(false-positive). Conclusion: Although a rather invasive procedure that requires general anesthesia and hospitalization, laparoscopy with laparoscopic ultrasonography was found to significantly contribute to the differential diagnosis of pancreatic cystic lesions.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 08:15:25