Computed tomography is important in assessing resectability of pancreatic carcinoma, even after ultrasonographic demonstration of the tumour.
In Finland pancreatic tumour is often detected initially on ultrasonography (US), which is widely used as a primary examination in patients who have epigastric pain or are jaundiced. This retrospective study was performed to investigate whether computed tomography (CT) provided any essential substantial staging information to US in patients, whose primary tumour was detected in US. Both US and CT had been performed in 102 pancreatic carcinoma patients. US, being performed always prior to CT, detected the pancreatic tumour in 73 patients (sensitivity 72%). CT detected pancreatic tumour in 65 of these 73 patients (89%). US demonstrated the tumour to be unresectable in 22 patients (30%). CT demonstrated the tumour as unresectable in the same 22 patients, but also in additional 20 patients (overall 42 patients = 58%, P less than 0.001 as compared to US). Three of these 20 patients underwent biliary bypass, but in 17 patients laparotomy was considered unnecessary (including the six patients who underwent merely exploratory laparotomy). It was estimated, that the 51 CT examinations, performed in patients in whom the pancreatic tumour was detected resectable on US, with overall costs of about FIM 137,700, might obviate laparotomy in 17 patients, with operative costs of about FIM 255,000. Thus, CT appears to provide essential substantial information to US about the resectability of pancreatic carcinoma, and CT can be considered a very important preoperative examination from both medical and economical point of view in the patients whose pancreatic tumour has been demonstrated by US.
Hyöty
M K
MK
Department of Surgery, University Hospital, Tampere, Finland.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography