山本 敏雄, 金田 真, 中村 菊洋, 久留宮 隆, 松田 信介, 伊佐地 秀司, 小倉 嘉文, 野口 孝, 川原田 嘉文, 水本 龍二

Toshio YAMAMOTO, Makoto KANEDA, Kikuhiro NAKAMURA, Takashi KURUMIYA, Sinsuke MATSUDA, Shouji ISAJI, Yoshifumi OGURA, Takashi NOGUCHI, Yoshifumi KAWARADA, Ryuuji MIZUMOTO

三重大学医学部第一外科

First Department of Surgery, Mie University School of Medicine

キーワード : Pancreatic carcinoma, Pancreatic mass, Extension of pancreatic carcinoma, Portal vein invasion

Endoscopic ultrasonography (EUS) findings before surgery were analysed in 12 patients with pancreatic tumors, these result were compared with operative findings and the resected specimen. Final diagnosis of pancreatic carcinoma was made in 9 cases (inclunding mucin producing pancreatic carcinoma in 2), mucin producing adenoma in one, non-functional islet cell tumor and mass-forming chronic pancreatitis one.
Except for one case with pancreatic cancer, all were detected as a mass by EUS. Diagnostic accuracy for extension of pancreatic carcinoma was compared between conventional ultrasonography (US) and EUS. The rate was 55.6% in US and 88.9% in EUS for portal vein invasion. On the other hand, for detecting duodenal (or gastric) invasion, US was not valuable, although diagnostic accuracy rate of EUS was only 55.6%. Detectability of lymph nodes in the hepatoduodenal ligament was higher in EUS than in US, although it was difficult to determine lymph node metastasis by EUS.
In conclusion, EUS is useful for the diagnosis of pancreatic tumors as well as their extension into the adjacent organs, especially portal vein invasion.