title: Increased Incidence of Benign Pancreatic Pathology following Pancreaticoduodenectomy for Presumed Malignancy over 10 Years despite Increased Use of Endoscopic Ultrasound.
abstract: Despite using imaging studies, tissue sampling, and serologic tests about 5-10% of surgeries done for presumed pancreatic malignancies will have benign findings on final pathology. Endoscopic ultrasound (EUS) is used with increasing frequency to study pancreatic masses. The aim of this study is to examine the effect of EUS on prevalence of benign diseases undergoing Whipple over the last decade. Patients who underwent Whipple procedure for presumed malignancy at Emory University Hospital from 1998 to 2011 were selected. Demographic data, history of smoking and drinking, history of diabetes and pancreatitis, imaging data, pathology reports, and tumor markers were extracted. 878 patients were found. 95 (10.82%) patients had benign disease. Prevalence of benign finding had increased over the recent years despite using more EUS. Logistic regression models showed that abdominal pain (OR: 5.829, 95% CI 2.681-12.674, P ≤ 0.001) and alcohol abuse (OR: 3.221, CI 95%: 1.362-7.261, P: 0.002) were predictors of benign diseases. Jaundice (OR: 0.221, 95% CI: 0.084-0.58, P: 0.002), mass (OR: 0.145, 95% CI: 0.043-0.485, P: 0.008), and ductal dilation (OR: 0.297, 95% CI 0.134-0.657, P: 0.003) were associated with malignancy. Use of imaging studies, ERCP, and EUS has not decreased the percentage of benign findings after surgery for presumed pancreatic malignancy.
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Shadi S
authors.initials: SS
authors.lastname: Yarandi
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Thomas
authors.identifier: 0000-0003-1101-8743
authors.initials: T
authors.lastname: Runge
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Zhijian
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Yueping
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Saurabh
authors.identifier: 0000-0001-6841-4929
authors.initials: S
authors.lastname: Chawla
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Woods
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Keilin
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Field F
authors.initials: FF
authors.lastname: Willingham
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Xu
authors.affiliation: Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Cai