Szövettanilag tisztázatlan pancreasfeji térfoglaló folyamatok sebészi megoldásának dilemmái.

Translated title of the contribution: Surgical aspects of histologically unproven space-occupying lesions of the pancreas head

A. Oláh, Tibor Belágyi, Akos Issekutz

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

A suspected, but unproved malignant tumor in the head of the pancreas is a fairly common problem for surgeon. Even intraoperatively, differentiation between chronic pancreatitis and carcinoma is difficult. We try to give guidelines about what can be done with a pancreas head mass intraoperatively without previous cytology or histology. When do we have to achieve definite diagnosis at all costs, and how can we achieve it? Results of 40 intraoperative aspiration cytologies, performed for suspected pancreatic cancer were analysed. All of them were controlled by histology in the resected specimen. Intraoperative biopsy was false negative in 12.5% and the diagnosis was uncertain in 35%. These data show that a benign result by itself never excludes the presence of malignancy. If pathology will alter our decision about resection, all efforts should be made to confirm the diagnosis. On the other hand, in a case of a mass lesion with obstructive symptoms, cytology does not alter the need for surgical decompression, and some kind of resection is a reasonable option, even in case of chronic pancreatitis. Nihilistic approach in the case of pancreatic head mass with suspected but unproved malignancy is not justified. Pancreatoduodenectomy should be performed for all tumors even without histologic confirmation if an experienced team can perform it with low postoperative morbidity and mortality.

Original languageHungarian
Pages (from-to)24-26
Number of pages3
JournalMagyar sebészet
Volume55
Issue number1
Publication statusPublished - 2002

Fingerprint

Pancreas
Cell Biology
Chronic Pancreatitis
Neoplasms
Histology
Surgical Decompression
Pancreaticoduodenectomy
Pancreatic Neoplasms
Guidelines
Pathology
Morbidity
Carcinoma
Biopsy
Costs and Cost Analysis
Mortality

Cite this

Szövettanilag tisztázatlan pancreasfeji térfoglaló folyamatok sebészi megoldásának dilemmái. / Oláh, A.; Belágyi, Tibor; Issekutz, Akos.

In: Magyar sebészet, Vol. 55, No. 1, 2002, p. 24-26.

Research output: Contribution to journalArticle

@article{3dea363c39b8488d8fcfa85ac0041273,
title = "Sz{\"o}vettanilag tiszt{\'a}zatlan pancreasfeji t{\'e}rfoglal{\'o} folyamatok seb{\'e}szi megold{\'a}s{\'a}nak dilemm{\'a}i.",
abstract = "A suspected, but unproved malignant tumor in the head of the pancreas is a fairly common problem for surgeon. Even intraoperatively, differentiation between chronic pancreatitis and carcinoma is difficult. We try to give guidelines about what can be done with a pancreas head mass intraoperatively without previous cytology or histology. When do we have to achieve definite diagnosis at all costs, and how can we achieve it? Results of 40 intraoperative aspiration cytologies, performed for suspected pancreatic cancer were analysed. All of them were controlled by histology in the resected specimen. Intraoperative biopsy was false negative in 12.5{\%} and the diagnosis was uncertain in 35{\%}. These data show that a benign result by itself never excludes the presence of malignancy. If pathology will alter our decision about resection, all efforts should be made to confirm the diagnosis. On the other hand, in a case of a mass lesion with obstructive symptoms, cytology does not alter the need for surgical decompression, and some kind of resection is a reasonable option, even in case of chronic pancreatitis. Nihilistic approach in the case of pancreatic head mass with suspected but unproved malignancy is not justified. Pancreatoduodenectomy should be performed for all tumors even without histologic confirmation if an experienced team can perform it with low postoperative morbidity and mortality.",
author = "A. Ol{\'a}h and Tibor Bel{\'a}gyi and Akos Issekutz",
year = "2002",
language = "Hungarian",
volume = "55",
pages = "24--26",
journal = "Magyar Sebeszet",
issn = "0025-0295",
publisher = "Ifjusagi Lapkiado Vallalat",
number = "1",

}

TY - JOUR

T1 - Szövettanilag tisztázatlan pancreasfeji térfoglaló folyamatok sebészi megoldásának dilemmái.

AU - Oláh, A.

AU - Belágyi, Tibor

AU - Issekutz, Akos

PY - 2002

Y1 - 2002

N2 - A suspected, but unproved malignant tumor in the head of the pancreas is a fairly common problem for surgeon. Even intraoperatively, differentiation between chronic pancreatitis and carcinoma is difficult. We try to give guidelines about what can be done with a pancreas head mass intraoperatively without previous cytology or histology. When do we have to achieve definite diagnosis at all costs, and how can we achieve it? Results of 40 intraoperative aspiration cytologies, performed for suspected pancreatic cancer were analysed. All of them were controlled by histology in the resected specimen. Intraoperative biopsy was false negative in 12.5% and the diagnosis was uncertain in 35%. These data show that a benign result by itself never excludes the presence of malignancy. If pathology will alter our decision about resection, all efforts should be made to confirm the diagnosis. On the other hand, in a case of a mass lesion with obstructive symptoms, cytology does not alter the need for surgical decompression, and some kind of resection is a reasonable option, even in case of chronic pancreatitis. Nihilistic approach in the case of pancreatic head mass with suspected but unproved malignancy is not justified. Pancreatoduodenectomy should be performed for all tumors even without histologic confirmation if an experienced team can perform it with low postoperative morbidity and mortality.

AB - A suspected, but unproved malignant tumor in the head of the pancreas is a fairly common problem for surgeon. Even intraoperatively, differentiation between chronic pancreatitis and carcinoma is difficult. We try to give guidelines about what can be done with a pancreas head mass intraoperatively without previous cytology or histology. When do we have to achieve definite diagnosis at all costs, and how can we achieve it? Results of 40 intraoperative aspiration cytologies, performed for suspected pancreatic cancer were analysed. All of them were controlled by histology in the resected specimen. Intraoperative biopsy was false negative in 12.5% and the diagnosis was uncertain in 35%. These data show that a benign result by itself never excludes the presence of malignancy. If pathology will alter our decision about resection, all efforts should be made to confirm the diagnosis. On the other hand, in a case of a mass lesion with obstructive symptoms, cytology does not alter the need for surgical decompression, and some kind of resection is a reasonable option, even in case of chronic pancreatitis. Nihilistic approach in the case of pancreatic head mass with suspected but unproved malignancy is not justified. Pancreatoduodenectomy should be performed for all tumors even without histologic confirmation if an experienced team can perform it with low postoperative morbidity and mortality.

UR - http://www.scopus.com/inward/record.url?scp=0036482999&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036482999&partnerID=8YFLogxK

M3 - Article

C2 - 11930559

AN - SCOPUS:0036482999

VL - 55

SP - 24

EP - 26

JO - Magyar Sebeszet

JF - Magyar Sebeszet

SN - 0025-0295

IS - 1

ER -