Screening for hilar biliary invasion in ampullary cancer patients  

作　　者：Tadayuki Takagi Mitsuru Sugimoto Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Jun Nakamura Mika Takasumi Minami Hashimoto Tsunetaka Kato Ryoichiro Kobashi Takumi Yanagita Yuko Hashimoto Shigeru Marubashi Takuto Hikichi Hiromasa Ohira 

机构地区：[1]Department of Gastroenterology,Fukushima Medical University,Fukushima 960-1295,Japan [2]Department of Endoscopy,Fukushima Medical University Hospital,Fukushima 960-1295,Japan [3]Department of Pathological Diagnosis,Fukushima Medical University,Fukushima 960-1295,Japan [4]Department of Hepato-Biliary-Pancreatic and Transplant Surgery,Fukushima Medical University,Fukushima 960-1295,Japan

出　　处：《World Journal of Gastrointestinal Endoscopy》2022年第9期536-546,共11页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND The treatment for ampullary cancer is pancreatoduodenectomy or local ampullectomy.However,effective methods for the preoperative investigation of hilar biliary invasion in ampullary cancer patients have not yet been identified.AIM To determine the necessity of and an appropriate method for investigating hilar biliary invasion of ampullary cancer.METHODS Among 43 ampullary cancer patients,34 underwent endoscopic treatment(n=9)or surgery(n=25).The use of imaging findings(thickening and enhancement of the bile duct wall on contrast-enhanced computed tomography,irregularity on endoscopic retrograde cholangiography,thickening of the entire bile duct wall on intraductal ultrasonography(IDUS),and partial thickening of the bile duct wall on IDUS)and biliary biopsy results for diagnosing hilar biliary invasion of ampullary cancer was compared.RESULTS Hilar invasion was not observed in every patient.Among the patients who did not undergo biliary stent insertion,the combination of partial thickening of the bile duct wall on IDUS and biliary biopsy results showed the highest accuracy(100%)for diagnosing hilar biliary invasion.However,each imaging method and biliary biopsy yielded some false-positive results.CONCLUSION Although some false-positive results were obtained with each method,the combination of partial thickening of the bile duct wall on IDUS and biliary biopsy results was useful for diagnosing hilar biliary invasion of ampullary cancer.However,hilar invasion of ampullary cancer is rare;therefore,the investigation of hilar biliary invasion of ampullary cancer might be unnecessary.

关 键 词：Ampullary cancer Biliary biopsy Contrast-enhanced CT Hilar biliary invasion Intraductal ultrasonography 

分 类 号：R735.0[医药卫生—肿瘤]