A novel surgical option for artery-involving pancreatic cancer: sub-adventitial divestment technique / 中华消化外科杂志

Radical resection remains as the key treatment to improve the prognosis of pancreatic cancer, and arterial invasion hinders radical resection for locally advanced lesions. More accurate assessment of resectability and selection of appropriate surgical techniques depend on better understanding of the anatomy, histology, and tumor biology of pancreatic cancer invasion to the artery. Traditional radiology assessment for artery involvement, based on the circumference of involved arteries, is not equivalent to pathological artery invasion. The depth of arterial invasion is more important than the circumference in evaluating resectability. Results of morphological observa-tion on arterial structure shows that both the feasibility of sub-adventitial divestment technique (SDT) and the necessity of arterial resection depend on whether the external elastic lamina of artery is invaded. The SDT can provide an opportunity for radical resection for pancreatic cancer with arterial invasion, while avoiding the high mortality and incidence of complications caused by arterial resection. A more precise assessment of tumor invasion depth and biological behavior will provide a more reliable basis for surgical decision for the treatment of locally advanced pancreatic cancer with arterial invasion.

The role of diagnostic laparoscopy in abdominal masses

Background: Diagnostic laparoscopy is an added tool that has become widely available for the assessment of abdominal masses in addition to conventional imaging. It is the best real time imaging technique due to the magnification and intense illumination provided. The aim of this work is the assessment of the impact of performing diagnostic laparoscopy at the start of operations intended for resection of an abdominal mass.Methods: This prospective study included 40 patients admitted for surgical resection of an abdominal mass. All Patients were subjected to thorough conventional investigations followed by diagnostic laparoscopy performed prior to the start of the definitive operation. We assessed the extra time needed, complications encountered, effect on decision making and the overall benefit of laparoscopy in this context.Results: Overall 21 patients (52.5%) did benefit from diagnostic laparoscopy somehow between upgrading the staging, affecting the laparotomy incision site and confirming feasibility of laparoscopic resection. Of the patients who proceeded to a laparotomy (n=30), diagnostic laparoscopy missed local invasion in 7 patients, which precluded the resection of the tumor in 5 of them. Only 1 complication related to diagnostic laparoscopy was encountered in the form of a port-site hematoma (2.5%).Conclusions: While diagnostic laparoscopy doesn't carry significant added morbidity, it might save the patient an unnecessary laparotomy by altering the preoperative staging and improving the accuracy of anatomical and pathological diagnoses. Laparoscopy has its limitations mainly in the assessment of the retroperitoneal space as well as direct tumor invasion to adjacent organs and vessels.

Incremental Role of Pancreatic Magnetic Resonance Imaging after Staging Computed Tomography to Evaluate Patients with Pancreatic Ductal Adenocarcinoma / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study was to investigate the impact of contrast enhanced pancreatic magnetic resonance imaging (MRI) in resectability and prognosis evaluation after staging computed tomography (CT) in patients with pancreatic ductal adenocarcinoma (PDA). MATERIALS AND METHODS: From January 2005 to December 2012, 298 patients were diagnosed to have potentially resectable stage PDA on CT. Patients were divided into CT+MR (patients underwent both CT and MRI; n=216) and CT only groups (n=82). Changes in resectability staging in the CT+MR group were evaluated. The overall survival was compared between the two groups. The recurrence-free survival and median time to liver metastasis after curative surgery were compared between the two groups. RESULTS: Staging was changed from resectable on CT to unresectable state on MRI in 14.4% of (31 of 216 patients) patients of the CT+MR group. The overall survival and recurrence-free survival rates were not significantly different between the two groups (p=0.162 and p=0.721, respectively). The median time to liver metastases after curative surgery in the CT+MR group (9.9 months) was significantly longer than that in the CT group (4.2 months) (p=0.011). CONCLUSION: Additional MRI resulted in changes of resectability and treatment modifications in a significant proportion of patients who have potentially resectable state at CT and in prolonged time to liver metastases in patients after curative surgery. Additional MRI to standard staging CT can be recommended for surgical candidates of PDA.

The role of EBUS-TBNA in the systematic evaluation of lymph node staging and resectability analysis in non-small cell lung cancer / 中华肿瘤杂志

Objective@#To evaluate the role of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) in lymph node staging and resectability assessment of patients with non-small cell lung cancer (NSCLC).@*Methods@#The clinical data of 154 patients with NSCLC who underwent EBUS-TBNA from March 2015 to December 2018 were collected. All accessible mediastinal and hilar lymph nodes were systematically explored and punctured using EBUS-TBNA. EBUS-TBNA and CT were used for preoperative staging and resectability evaluation.@*Results@#The sensitivity, specificity and accuracy of EBUS-TBNA were 94.2%, 100.0% and 96.0%, respectively, while those of CT were 89.9%, 31.8% and 72.0%, respectively. The differences were statistically significant (P<0.05). The sensitivity, specificity and accuracy of EBUS-TBNA in lymph nodes with short diameter less than 15 mm were 92.4%, 100.0% and 96.0%, respectively, while those of CT were 80.7%, 34.8% and 60.1%, respectively, with statistical differences (P<0.05). The staging of 62 patients was changed, 27 cases were up-regulated and 35 cases were down-regulated. Among them, 32 cases had been changed to resectable. The evaluating resectability of EBUS-TBNA showed excellent consistency with that of pathological results (Kappa=0.95). The sensitivity and specificity were 100.0% and 97.2%, respectively.@*Conclusion@#EBUS-TBNA can systemically evaluate the metastatic status of NSCLC patients and improve the accuracy of preoperative lymph node staging and resectability assessment.

Clinical value of precise staging for pancreatic carcinoma / 中华肝胆外科杂志

Pancreatic carcinoma remains one of the most challenging malignant tumor with an increasing morbidity in China.The significance of multidisciplinary and comprehensive treatment of pancreatic cancer has been recognized in recent years.Moreover,several novel clinical staging standards of pancreatic cancer have emerged to help optimize the treatment strategies and improve patients' prognosis in precise treatment era.Currently,in addition to the traditional TNM stage,usage of histologic grade (G),resection marginstatus (M),lymphatic invasion status (L),vascular invasion status (V),perineurial invasion status (P) and combination of these stages recommended by NCCN guideline as GTNMLVP stage have emerged.Other novel staging standards include respectability status,standardized pancreatic surgery classification,genetics classification,etc.This review summarized the characteristics and clinical significance of these novel established methods for pancreatic cancer precise staging.

Expert consensus of precise diagnosis and treatment for pancreatic head cancer using three-dimensional visualization technology / 中华外科杂志

Three-dimensional (3D) visualization technology in pancreatic head cancers could offer decision-making support to preoperative diagnosis, resectability assessment and individualized surgical planning. In addition, the pancreas 3D printing helps to realize the leapfrog development from 3D images to 3D physical models and provides better guidance of the precise surgery of complicated cancers of the pancreatic head. In order to standardize the application of 3D visualization and 3D printing technology in the diagnosis and treatment of pancreatic head cancer, Chinese experts in relevant fields were organized by four committees to formulate this expert consensus. This consensus give the suggestion from ten aspects on the treatment of pancreatic head cancer, such as the preoperative evaluation, acquisition method of CT data, the construction of three-dimensional visualization model, clinical classification of resectability assessment based on the 3D visualization technology, simulation surgery, 3D printing, the guidance with 3D visualization technology on pancreatic cancer surgery, intraoperative examination of resectability assessment, and the other treatment based on 3D visualization technology with pancreatic head cancer. The consensus will give the reference to the doctors who is developing or is going to develop the 3D visualization technology on pancreatic head cancer.

Frecuencia de tratamiento quirurgico curativo de las neoplasias periampulares. Experiencia en base a 122 casos / Frequency in curative surgical treatment of periampullary tumors. Experience based on 122 cases

Introducción Los tumores periampulares son aquellos que se desarrollan en un área de 2 cm próxima de la papila de Vater; en este grupo se encuentran los tumores de cabeza de páncreas, los de la ampolla de Vater, los del colédoco intrapancreático y duodenales. Objetivo: Determinar la frecuencia de tratamiento quirúrgico curativo de los tumores de la región periampular en el servicio de Cirugía General del Hospital Central del Instituto de Previsión Social. Metodología: Investigación retrospectiva, observacional descriptiva y de corte transverso en el periodo 2009-2015. Resultados Se estudiaron 122 casos, la frecuencia de tumores periampulares resecables intraoperatoriamente, y por tanto sometidos a duodeno pancreatectomía cefálica fue de 38.52%, que corresponde a 47 casos del total. La relación de varón/mujer fue de 1,3/1. El promedio de edad fue 64,67 años. La ictericia fue el signo y síntoma prevalente y el primero en aparecer. Se realizó ecografía y tomografía en todos los pacientes. Ningún paciente fue sometido a ecoendoscopia. El tipo histológico más frecuente fue adenocarcinoma ductal de páncreas con 89 casos (72,95%). Conclusión: La estatificación quirúrgica determinando la resecabilidad o no de dichos tumores es fundamental para evitar procedimientos cruentos innecesarios, la ecografía y tomografía son estudios necesarios para la determinación de resecabilidad, pero que muchas veces necesitan ser reforzados con otros estudios como la eco endoscopia que evitaría los falsos resecables que ingresan a quirófano innecesariamente. Situación encontrada muy frecuentemente en este estudio.

Introduction: Periampullary tumors are most often localizated in a 2 cm area next to the ampulla of Vater, and this group included the head of pancreas carcinoma, Vater´s ampulla carcinoma, intrapancreatic cholangiocarcinoma and duodenal carcinoma. Objective: to define the frequency of curative surgical treatment in tumors of periampullar region at the Service of General Surgery of Instituto de Previsión Social. Patients and Method: a retrospective, observational and descriptive study between 2009 and 2015. Results: In 122 cases, 47 of them (38,5%) had a resectability criteria and was performed a CDP surgery in these cases. There wasn´t difference of presentation according to gender. The average age was 64,67 years old. Jaundice was the first symptom showed and the most common. It was performed ultrasonography and CT scan in all patients. The most common histological type was the pancreatic ductal adenocarcinoma in 89 patients. Conclusion: The staging of the periampullar tumors and the resectabilty criteria are very important parameters to avoid an unnecessary surgical procedure. Ultrasonography and CT scan are important tools to clarify the resectability criteria, even better if they are accompanied by endoscopic ultrasound.

Advances in molecular biology and clinical practice of rectal liver metastases / 中华消化外科杂志

Colorectal cancer (CRC) is one of the most common malignancies,and liver metastases become the leading cause of high mortality of CRC patients.Difference in the anatomy between the colon and rectum resulting in different metastatic pattern and treatment methods between the colonic cancer and the rectal cancer.Recently,molecular-based subtyping is becoming the basis of prediction of tumor response and outcomes,replacing clinical and pathological stagings.In this review,clinical characteristics,advances of molecular detection,surgery and adjuvant therapy of rectal liver metastases are summarized.

Imaging diagnosis of pancreatic cancer and preoperative imaging evaluation of resectability and staging / 临床肝胆病杂志

Pancreatic cancer is an invasive malignant tumor with a high mortality rate. As the preferred imaging method for pancreatic imaging, multi-slice CT angiography can evaluate the presence or absence, extent, and degree of invasion of peripancreatic major vessels to provide reliable evidence for tumor staging and surgical resectability evaluation. As an important supplementary method of CT, magnetic resonance imaging has an important guiding value in disease diagnosis, liver metastasis, and prognostic evaluation. Vascular invasion of pancreatic cancer is the main indicator for preoperative evaluation of respectability. Lymph node metastasis, distant metastasis, neural invasion of pancreatic cancer, and hepatic artery abnormalities are influencing factors for patients′ prognosis. It is pointed out that preoperative imaging evaluation for patients with pancreatic cancer has guiding significance for the development of treatment regimens, selection of surgical procedures, and prognostic evaluation.

Surgical management of huge pelvic tumor: a report of 56 cases / 中华消化外科杂志

Objective To investigate the surgical management of huge pelvic tumor.Methods The clinical data of 56 patients with huge pelvic tumor who were admitted to the Cancer Hospital of Henan Province from February 2005 to January 2012 were retrospectively analyzed.Tumor resectability was assessed via enhanced computed tomography or three-dimensional reconstruction,and the tumors were freed and resected by combination of muliiple surgical approaches.All the patients were followed up via telephone or re-examination at the out-patient department to learn the recurrence and metastasis of tumor.The survival rate was calculated using the life table.Results Fifty patients received preoperative computed tomography examination,and the imaging data of 6 patients were three-dimensionally reconstructed.Preoperative evaluation showed that 49 patients needed combined multivisceral resection,5 needed tumor resection,and the tumors of 2 patients were unresectable.Fourteen patients were diagnosed preoperatively,and 8 patients were diagnosed by intraoperative rapid frozen section examination,and the rest 34 patients were diagnosed by postoperative pathological examination.The surgical approaches including anterior median sacral approach combined with transperineal coccyx anterior approach (21 patients),anterior median sacral approach (11 patients),obturator approach (8 patients),retropubic approach (8 patients) and obturator approach combined with transperineal approach of coccyx (8 patients).Tumor and rectum resection was carried out on 18 patients,tumor and partial bladder resection on 12 patients,tumor,uterus and ovariectomization on 12 patients,tumor,part of the small intestine and colorectal resection on 10 patients,tumor and total pelvic exenteration on 4 patients.In all the 56 patients,53 achieved R0 resection,2 cases reached naked eye clean,1 case had residual tumor.The mean operation time was 100 minutes.Fifty patients recovered uneventfully.Six patients had postoperative complications,including 3 patients with intestinal obstruction (2 patients were cured by conservative treatment,and 1 patient was cured by surgery),2 patients with pelvic infection and 1 patient with colostomy hernia,and they were cured by drainage and nutritional support.One patient died of postoperative myocardial infarction.The results of postoperative pathologic study showed that 25 patients were with adenocarcinoma,16 with sarcoma and 15 with gastrointestinal stromal tumor.Forty-seven patients were followup to December 2012,and the 5-year survival rate was 26.7％ for patients with adenocarcinoma,18.9％ for patients with sarcoma,and 52.6％ for patients with gastrointestinal stromal tumor.Conclusion Preoperative assessment of resectability of huge pelvic tumor can reduce unnecessary laparotomy and improve the safety of operation.

Clinical research of treatment effect of minimally invasive excision in intrahepatic bile duct stones / 局解手术学杂志

Objective To investigate the treatment effect of minimally invasive excision in intrahepatic bile duct stones. Methods Ac-cording to different treatment methods, 280 patients with intrahepatic bile duct stones were divided into the treatment group (180 cases) and the control group(100 cases). The control group were given open hepatic lobectomy while the treatment group were given minimally invasive treatment of hepatic lobectomy by laparoscopy. Results All patients had successfully completed surgery and the stones were removed. Compared the operation time,intraoperative blood loss,and blood transfusion of the two groups,and there were no statistically significance (P>0. 05). The postoperative hospitalization,time of drainage tube remove, time of analgestic drug use in treatment group were obviously lower than those in control group,which had statistically significance (P<0. 05). The common postoperative complications of the two groups were bile leakage,wound infection,pleural effusion and subphrenic abscess,et al. The complication rate of treatment group was 2. 2%, while it was 10. 1% in the control group, which had significant difference (P<0. 05). All the patients were followed-up for 6 months, and there was no death in patients. Conclusion Intrahepatic bile duct stones in progress could be treated by hepatic resection surgery. Laparoscopic techniques could accelerate the recovery of patients and reduce the complication rate,and it would become a new treatment option.

Neo-adjuvant chemotherapy in advanced hypopharyngeal carcinoma.

Objective: The aim of this retrospective study was to find out the role of neo-adjuvant chemotherapy (NACT) in changing the management and outcome of advanced hypopharyngeal cancer patients. Materials and Methods: This is a retrospective analysis of 59 treatment naïve, advanced hypopharyngeal cancer patients presenting to our tertiary care center from April 2010 to October 2011. NACT was given as two (platinum with taxane) or three drug with (platinum, taxane with 5-flurouracil [5 FU]) as 3 weekly regimen with cisplatin and docetaxel as 75 mg/m 2 each, 5-FU as 1000 mg/m 2 . NACT was either given with the intent of achieving: (1) surgical resection (extensive soft tissue disease, oropharyngeal involvement, extensive disease with cartilage erosion) or (2) organ preservation (Bulky disease with inner cartilage erosion, exolaryngeal disease without cartilage erosion, large N3 nodes). Results: The mean age of this population was 55 years. Most (83%) of the patients had pyriform sinus (PFS) involvement. 69% patients had Stage IVa disease, 21% Stage IVb and 10% Stage III. The overall response rate was 66%, including 06% complete responses and 60% partial responses. Following NACT, resectability was achieved in 30% (10/33) and organ preservation protocol was planned after NACT in 73% (19/26) patients. The main toxicities were neutropenia (grade 3, 4, 04%; febrile neutropenia, 4%), mucositis 5%, diarrhea 5%. The median progression free survival was 20 months. Conclusions: NACT can be useful in patients with oropharyngeal involvement to achieve surgical resection and larynx preservation in patients with bulky T3 disease.

Classification, staging, and resectability assessment for hilar cholangiocarcinoma / 中华肝胆外科杂志

Hilar cholangiocarcinoma is a type of malignant tumor of the extrahepatic ductal system.Due to hepatic artery and portal vein involvement within the liver hilum,the resection rate is low and the prognosis is poor.However,with several advances in imaging technology achieved during the last decades,the accuracy of diagnosing and assessing the resectability of hilar cholangiocarcinoma has been greatly improved.In fact,some new classification and staging systems have been proposed to evaluate the tumor.This review will discuss the recent advances in the classification,staging,and preoperative resectability assessment for hilar cholangiocarcinoma.

Preoperative assessment strategies of hilar cholangiocarcinoma / 国际外科学杂志

At present,in the opinions of the domestic and foreign scholars,the only hope of long-term survival even cure of hilar cholangiocarcinoma was obtained by radical resection(ie R0 resection).The application of preoperative assessment with appropriate and comprehensive strategies can judge the respectability and Intraoperative safety accurately to the tumor,thereby it can improve the radical resection rate and safety of patients with hilar cholangiocarcinoma.In this paper,preoperative assessment strategies are reviewed.

Minimally invasive surgery for resectable colorectal cancer with liver metastases: a prospective study / 中华肝胆外科杂志

Objective To prospective study the use of minimally invasive surgery (MIS) for colorectal cancer with liver metastases (CRCLM) and to analyze the safety and survival outcomes.Methods 31 patients with resectable CRCLM were enrolled into this study from January 2009 to August 2011.Synchronous or metachronous liver metastases were diagnosed in 26 and 5 patients,respectively.The treatment strategy was discussed and decided by a multi disciplinary team which consisted of experienced colorectal surgeons,hepatic surgeons,medical oncologists,radiologists,and pathologists.Treatment included the use of neoadjuvant chemotherapy,one or two-staged surgery,and suitability to use laparoscopic surg(e)ry.Results Coloproctectomy and partial hepatectomy were carried out in all these patients,and every patient received at least one laparoscopic procedure.The operations in cluded: laparoscopic coloproctectomy plus hepatectomy (n=10),laparoscopic coloproctectomy only (n 18) and laparoscopic partial hepatcctomy only (n=3).One-staged coloproctectomy and hepatectomy were performed in 19 patients who presented with synchronous CRCLM.Colorectal and hepatic specific complications,such as anastomotic leak,liver failure,biliary leak,abdominal infection and abdominal bleeding,were not detected in these pati(e)nts.Neoadjuvant chemotherapy was used in 12 patients.Adjuvant chemotherapy was given to every patient.At a mean follow-up of 23.3 months from the diagnosis of liver metastases,the overall survival and disease-free survival were 87.1％ and 71.0％,respectively.Conclusions MIS for resectable CRCLM in carefully selected patients was safe and feasible.A one staged laparoscopic coloproctectomy and partial hepatectomy was possible.The short-middle oncologic outcomes were acceptable,but the long-term survival was still not clear.

Application of medical image three dimensional visualization system in the evaluation of resectability of pancreatic and periampullary cancer / 中华消化外科杂志

Pancreatic cancer is malignant with a poor prognosis,and its incidence is rising worldwide in recent years.Multiple slices spiral computed tomography and computed angiography are the first choice for the diagnosis of pancreatic cancer,while misdiagnosis of pancreatic cancer still exists.From August 2009 to October 2011,80 patients with pancreatic or periampullary cancer were diagnosed using the medical image three dimensional visualization system (MI-3DVS).The threedimensional models of the liver,pancreas,vascular system and tumors were reconstructed successfully based on the 64-slice spiral computed tomography data.According to the analysis of the three dimensional models,4 patients underwent standard pancreaticoduodenectomy,1 received palliative surgery.MI3DVS plays an important role in the diagnosis and assessement of resectability of pancreatic and periampullary cancer.

Strive to improve the resection rate of pancreatic cancer / 中华消化外科杂志

With the increasing incidence and high malignancy, pancreatic cancer is still expected to be treated by radical resection. However, because of the unique anatomical and biological features, such as rapid progression, early metas-tasis and direct invasion to the vessels, the resection rate of pan-creatic cancer is still at a lower level. The standard procedures of diagnosis and treatment, including early detection, preopera-tive resectability assessment, and judgement of the resection area based on the tumor staging, benefit the patients and significantly improve the prognosis.

Gallbladder carcinoma: CT staging and operation resectability / 国际外科学杂志

Objective To analyze the CT staging and evaluate its role in assessing the resectability of the gallbladder carcinoma.Methods The CT scans of 47 patients who had pathologically confirmed gallbladder carcinoma were retrospectively reviewed and the CT stages of gallbladder carcinoma were used to evaluate the resectability.Results Before operation,three patients were in stage Ⅰ(6.4%,3/47),14stageⅡ(29.8%,14/47),10 stageⅢ(21.7%,3/47),20 stage Ⅳ(42.6%,20/47),however,after operation,three patients were in stage Ⅰ(6.4%,3/47),14 stageⅡ(29.8%,14/47),8 stage Ⅲ(17.0%%,8/47),22 stage Ⅳ(42.6%,20/47).The accurate rate of CT staging confirmed by operation was 91.5%(43/47).The treatment procedures of gallbladder carcinomas included radical operation,palliative excision and exploratory laparotomy.For 47 patients with gallbladder carcinomas,radical operation was performed in 30 cases(3 stage Ⅰ,14 stageⅡ,7 stage Ⅲ,6 stage Ⅳ),palliative excision 15 cases(1 stage Ⅲ,14 stage Ⅳ),exploratory laporatory 2 eases(2 stage Ⅳ).Conclusion The staging of gallbladder carcinoma with CT may provide definite value in evaluating respectability of gallbladder carcinoma.

Analysis of the appearances of multiple MRI sequences and the assessment of resectability in caput pancreatic carcinoma / 重庆医科大学学报

Objective:To analyze the appearances of multiple MRI sequences and the accuracy of the assessment of resectability in caput pancreatic carcinoma.Methods:MRI appearances were analyzed retrospectively in nineteen patients with histopathology or clinical examination proved carcinoma in the head of pancreas,and the assessment of resectability was compared with the findings of surgical and histopathology.Plain MRI sequences included:coronal scanning with T2-weighted 2D true-fast imaging with steady-state free precession,axial scanning using T1-weighted fast low angle single shot with fat suppression,T2-weighted half-Fourier single shot turbo spin-echo with fat suppression,and MRI cholangiopancreatography.The contrast-enhanced scanning procedures were axial scanning using T1-weighted 3D volume interpolated breathhold examination with fat suppression,the imaging were obtained during arterial phase,portal vein and delayed phase scanning.Results:Of 19 lesions in these patients,17 lesions showed hypo-intensity on T1WI of plain sequences,and normal pancreats showed hyper-intensity.15 lesions showed hyper-intensity or immingled-intensity on T2WI,one appended with cyst.During pancreatic arterial phase,18 lesions did not show enhancement,contrasting with the normal pancreas showing evidently enhancement,so the borderline of carcinoma was clear.During portal vein and delayed phase,17 lesions showed inhomogeneous slight enhancement,peripheral vas of pancreas in 17 cases were contacted or involved by tumor.3 transfer lesions in hepar showed slight enhancement.13 cases showed dilatation at both common bile duct and pancreatic duct as a typical double duct sign on MRCP.According to the assessment of MRI,7 cases could be resected,and 12 cases could not be resected.The assessment of 14 cases agreed with the surgical and histopathological findings.Conclusion:Carcinoma of pancreatic head is shown with many features on multiple MRI sequences.MRI examination has a high accuracy for the diagnosis and the assessment of resectability in carcinoma of pancreatic head,which is helpful in choosing project of therapy.

Accuracy of conventional CT in predicting resectability of cholangiocarcinoma: A retrospective review.

Objective : Cholangiocarcioma is the common malignant bile duct tumor Thailand, particularly in the Northeastern part of the country. Since tumor resection is the curative treatment for Cholangiocarcioma, preoperative imaging plays and important role in evaluating the extension and resectability status of this tumor. This present work was designed to assess the capability of cinventional CT scan in predicting the resectability of Cholangiocarcioma. Materials and methods : Conventional CT of twenty three patients who had pathologically proven Cholangiocarcioma, were retrospectively reviewed between January 2002 and Decem ber 2002. The CT images were interpreted by 2 gastrointestinal radiologists with consensus. Results : The accuracy was 87%, positive predictive value 57% and negative predictive value 100%. Conclusion : CT scan remains and important tool that can provide valuable information regarding the criteria for resectability.