Value of multidetector CT on aiding intraoperative judgement of serosal invasion of gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the value of multidetector CT on aiding intraoperative judgement of serosal invasion of gastric cancer.</p><p><b>METHODS</b>Clinical data of 206 cases of gastric cancer undergoing radical surgery in the First Hosptial of China Medical University from August 2009 to June 2011 were analyzed retrospectively. Preoperative CT findings and intraoperative judgement of serosal invasion in gastric cancer were compared with pathological results in order to investigate their values.</p><p><b>RESULTS</b>The sensitivity and specificity of preoperative CT findings and intraoperative judgement of serosal invasion were 88.5%, 81.5% and 98.9%, 61.3%, respectively. The accuracy of preoperative CT in diagnosing serosal invasion was higher than that of intraoperative judgement, while the difference was not statistically significant (84.5% vs. 77.2%, P=0.060). The rates of serosal invasion of normal type, reactive type, nodular type, tendonoid type and color-diffused type were 0 (0/29), 2.5% (1/40), 40.5% (15/37), 59.2% (29/49), and 82.4% (42/51) respectively. The accuracy of preoperative CT in diagnosing serosal invasion of gastric cancer with tendonoid type was higher than that of intraoperative judgement, and the difference was statistically significant (61.2% vs. 87.8%, P=0.002).</p><p><b>CONCLUSIONS</b>Multidetector CT plays an important role in aiding intraoperation judgement of serosal invasion of gastric cancer. For gastric cancer with tendonoid and color-diffused macroscopic serosal appearance, surgeons should pay attention to the value of preoperative CT findings.</p>

Clinical analysis of autoimmune pancreatitis: a single center study of 14 consecutive cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the characteristic findings of autoimmune pancreatitis (AIP) to increase the recognition of AIP.</p><p><b>METHODS</b>From February 2002 to April 2008, a total of 14 cases of AIP were reviewed by clinical, imaging, serologic, histopathologic features and treatment response. There were 13 male and 1 female, with a mean age of 53 years. The main clinical manifestations included progressive obstructive jaundice in 11 cases, upper abdomen pain in 3 cases.</p><p><b>RESULTS</b>Diffuse enlargement of pancreas and diffuse narrowing of the main pancreatic duct (MPD) were observed in 11 cases, while 3 patients showed localized pancreatic head enlargement and focal narrowing of the MPD. Distal common bile duct stenosis was found in all cases. Increased expression of serum immunoglobulin G was found in 7 patients. Autoantibody test was positive in 5 of 12 patients. Nine of 14 patients with AIP had extrapancreatic organ involvement. Massive lymphocytes and plasma cells infiltration in pancreatic tissues were showed on pathology, as well as parenchymal fibrosis. Seven earlier patients were treated initially with surgical laparotomy or resection for suspected malignancy. Steroid therapy was given to the other patients and was responsive. There were 4 recurrences after initial treatment.</p><p><b>CONCLUSION</b>AIP should be a differential diagnosis in pancreatic head mass in order to avoid unnecessary resection.</p>