Investigation of preoperative anemia and perioperative blood transfusion in patients with duodenal papillarycarcinoma in a tertiary hospital / 中国输血杂志

【Objective】 To investigate the preoperative anemia and perioperative blood transfusion in patients with duodenal papillary carcinoma who underwent Whipple surgery. 【Methods】 The clinical data of 1 959 cases with duodenal papillary carcinoma, subjected to Whipple surgery, were retrospectively analyzed. 【Results】 The rate of anemia in preoperative patients with duodenal papillary carcinoma was 54.87%(1 075/1 959). The incidence rate of anemia in the three age groups from low to high was 44.92% (≤50 years old, 190/423), 52.82% (51~64 years old, 506/958), and 65.57% (≥65 years old, 379/578) (P<0.05), and the highest rate of anemia occurred in patients aged above 65. There was a significant statistical difference among patients with different body mass index (BMI)(P<0.05). Patients with moderate or severe anemia received more red blood cells than patients with mild anemia during the perioperative period (P<0.05). The average hospitalization time of the blood transfusion patients was 27.25 days, and that of non-transfusion patients was 22.22 days (P<0.05). The amount of blood loss and hospitalization time of patients underwent laparoscopic and robotic surgery were significantly lower than those underwent open surgery patients (P <0.05). There were only 24.09%(186/772) treated with drugs for anemia intervention and the majority of patients (75.91%, 586/772) were treated with blood transfusions to interfere with anemia during hospitalization. 【Conclusion】 There are significant differences in the incidence rate of preoperative anemia among patients with duodenal papillary carcinoma who undergone Whipple surgery. Low BMI, abnormal WBC, and perioperative blood transfusion are high-risk factors for prolonged hospital stay, whereas anemia is not associated with prolonged hospital stay.

CT and MRI imaging features of carcinoma of the duodenal papilla / 中华肝胆外科杂志

In this article,we reviewed the CT/MRI imaging features of carcinoma of the duodenal papilla in 15 cases.The characteristic CT and MR imaging findings of duodenal papillary carcinoma included mass in the descending part of the duodenum,the mass and duodenum wall showed a "target" sign or " diamond ring" sign;a ring-enhancing lesions around the distal end of the common bile duct/pancreatic duct,and thickening of the wall of the second portion of the duodenum near the papilla.The use of MPR MDCT images and MRI coronal images are very useful to show these imaging features as an aid in early diagnosis of carcinoma of the duodenal papilla.

CT and MRI imaging features of carcinoma of the duodenal papilla / 中华肝胆外科杂志

In this article,we reviewed the CT/MRI imaging features of carcinoma of the duodenal papilla in 15 cases.The characteristic CT and MR imaging findings of duodenal papillary carcinoma included mass in the descending part of the duodenum,the mass and duodenum wall showed a "target" sign or " diamond ring" sign;a ring-enhancing lesions around the distal end of the common bile duct/pancreatic duct,and thickening of the wall of the second portion of the duodenum near the papilla.The use of MPR MDCT images and MRI coronal images are very useful to show these imaging features as an aid in early diagnosis of carcinoma of the duodenal papilla.

Differential diagnosis of vater ampulla carcinoma with MRI combined sequence examination / 实用放射学杂志

Objective To investigate the value of multiple sequential MRI in the differential diagnosis of vater ampulla carcinoma (VPC).Methods MRI data of 53 patients with VPC confirmed by surgery and pathology were analyzed retrospectively,which included 17ampullary carcinomas,15 pancreatic head carcinomas,10 duodenal papillary carcinomas and 11 distal common bile duct carcinomas.All patients underwent routine MRI plain scan,MRCP and multi-phase dynamic enhancement scan for the upper abdomen.The morphological characteristics and model of multi-phase dynamic enhancement of the tumor,and the morphological changes of pancreaticobiliary duct were focused,and relevant data were also measured.Results The differences of tumor size,central location,and signal homogeneity among the four different histological types showed statistical significance(P＜0.05),and their patterns of multi-phase dynamic enhancement also had differences.Double-segment sign was most found in VPC (26/53),four-segment sign was easy showed in pancreatic head carcinoma (8/15)and three-segment sign in distal common bile duct carcinoma (8/11).Beak sign was common seen in ampullary carcinoma(10/17),rat-tail sign was easy discovered in pancreatic head carcinoma (7/15) and truncated sign in distal common bile duct carcinoma(10/11).Diameter of major pancreatic duct in pancreatic head carcinoma was maximum and minimum in distal common bile duct carcinoma,and their difference had statistical significance(P＜0.05).Distance between obstructive end of bile common duct and major papilla of duodenum,and between obstructive end of major pancreatic duct and major papilla of duodenum as well as the pancreaticobiliary conjunction angle in pancreatic head carcinoma and distal common bile duct carcinoma were greater than that in ampullary carcinoma and duodenal papillary carcinoma.Conclusion MRI can prominently demonstrate various imaging characteristics of VPC with different histological origins.It is very valuable in the differential diagnosis of VPC with different histological types by comprehensive analysis of these findings.