| 췌장의 관강내 유두상 점액 종양: 췌장절제방법을 결정하는 데 있어 관강내 세경초음파 단층촬영술의 역할 |
| 백승훈·조영덕·장재영·천영국·김영석·문종호·김연수·이문성·허경열·심찬섭·김부성 |
| 순천향대학교 의과대학 내과학교실, 소화기연구소 |
| Intraductal Papillary Mucinous Neoplasm of the Pancreas: The Role of Intraductal Ultrasonography in Selection of Resection Method of Pancreas |
| Seung Hoon Baek, M.D., Young Deok Cho, M.D., Jae Young Jang, M.D., Young Koog Cheon, M.D., Young Seok Kim, M.D., Jong Ho Moon, M.D., Yun Soo Kim, M.D., Moon Sung Lee, M.D., Kyung Yul Hur, M.D., Chan Sup Shim, M.D. and Boo Sung Kim, M.D. |
| Institute for Digestive Research, Digestive Disease Center, Soon Chun Hyang University, College of Medicine, Seoul, Korea |
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| Abstract |
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Background/Aims:
The treatment of choice of intraductal papillary mucinous neoplasm (IPMN) is partial pancreatic resection with complete excision of this potentially malignant lesion, thus preserving sufficient pancreatic tissue to ensure endocrine and exocrine functions. This strategy, however, requires a reliable preoperative assessment of the highly variable extension of IPMN. We performed this study to determine the role of intraductal ultrasonography (IDUS) in predicting the extension of IPMN and selecting the resection methods of pancreas.
Methods:
A preoperative assessment of IPMN by IDUS was performed in 12 patients who underwent a surgical resection of IPMN. According to the preoperative localization of IPMN by IDUS, various types of limited pancreatic resections were planned. The histologic examination of the frozen section of the pancreatic cut surface was performed in all patient. In the cases of tumor involvement as cut surface margin, a modification of the planned pancreatic resection was done.
Results:
Technical success was achieved in all 12 cases (100%). There were positive tumor margin of cut surfaces in 2 patients. Of 10 cases whose frozen tissue evaluation of the pancreatic cut surface had been negative at first, one patieat has turned out to be margin positive in permanent section examination, finally. Overall accuracy of IDUS in predicting the continuous extension of IPMN was 75%.
Conclusions:
IDUS is a reliable diagnostic modality to guide the resection extent of the pancreas in patients with IPMN. (Korean J Gastrointest Endosc 2005;31:9096) |
| Key Words:
Intraductal papillary mucinous neoplasm, Intraductal ultrasonography |
| 주요어:
췌관내유두상점액종양, 관강내세경초음파단층촬영술 |
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