Pancreaticoduodenectomies in patients without periampullary neoplasms: lesions that masquerade as cancer

Michael G. Hurtuk, Margo Shoup, Kiyoko Oshima, Sherri Yong, Gerard V. Aranha

Research output: Contribution to journalArticle

Abstract

Background: Most pancreaticoduodenectomies (PDs) are performed to treat periampullary malignancies (PMs). Final pathologic analysis on these specimens does not always contain PMs. Our aim was to classify diseases that preoperatively mimic PMs. Methods: A prospective database of PDs performed at a single institution was reviewed. Clinicopathologic data on patients without PM on pathologic review with preoperative suspicion of PM were studied. Results: Of the 461 PDs performed at our institution, 45 (10%) had no PM; of these cases, 35 (78%) were performed for a clinical suspicion of malignancy. The final pathologic review showed chronic pancreatitis (CP) in 23 (66%) patients, biliary tract disease in 10 (28%) patients, duodenal ulcer in 1 (3%) patient, and distal common bile duct stricture with localized pancreatic fibrosis in 1 (3%) patient. Conclusion: Most patients undergoing PD have evidence of a PM. A subset of patients may have lesions that mimic a PM. In these patients, when PM cannot be ruled out, if possible, they should be offered PD.

Original languageEnglish (US)
Pages (from-to)372-376
Number of pages5
JournalAmerican journal of surgery
Volume199
Issue number3
DOIs
StatePublished - Mar 1 2010
Externally publishedYes

Keywords

  • Benign pancreatic lesions
  • Pancreaticoduodenectomy

ASJC Scopus subject areas

  • Surgery

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