The Differential Diagnosis and Prognosis of an Ampulla of Vater Cancer with a Grossly Normal Appearance.
- Author:
Ji Bong JEONG
1
;
Yong Tae KIM
;
Yong Jin JUNG
;
Ji Won KIM
;
Byung Kwan KIM
;
Kook Lae LEE
;
Ji Kon RYU
;
Yong Bum YOON
Author Information
1. Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul, Korea. yongtkim@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Ampulla of Vater cancer
- MeSH:
Alanine Transaminase;
Alkaline Phosphatase;
Ampulla of Vater;
Bilirubin;
Biopsy;
Common Bile Duct;
Constriction, Pathologic;
Diagnosis, Differential;
Follow-Up Studies;
Humans;
Liver Function Tests;
Medical Records;
Prognosis;
Retrospective Studies;
Survival Rate
- From:Korean Journal of Gastrointestinal Endoscopy
2008;37(3):185-191
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The purpose of this study was to determine the clinical parameters for a differential diagnosis between a malignant and benign stricture of the ampulla of Vater with a grossly normal appearance and to evaluate the diagnostic accuracy of the use of an endoscopic biopsy for the prognosis of ampulla of Vater cancers. METHODS: Medical records and cholangiograms were retrospectively reviewed. In order to determine the clinical parameters useful for a differential diagnosis, clinical manifestations, laboratory findings and the common bile duct diameter were compared between malignant and benign strictures. The diagnostic accuracy of the use of an endoscopic biopsy and the clinical features of patients with an ampulla of Vater cancer were analyzed. The survival rate after management was also evaluated. RESULTS: Nine patients with a benign stricture and 15 patients with a malignant stricture were included in this study. The levels of serum bilirubin, alkaline phosphatase and alanine aminotransferase were significantly higher in patients with a malignant stricture than in patients with a benign stricture (p<0.05). Of the patients who underwent surgical management, 93% had stage I or II disease. All of the patients were alive up to a mean follow-up period of 50 months. CONCLUSIONS: Liver function tests and the use of an endoscopic biopsy are useful in the differential diagnosis of a stricture of the ampulla of vater with a grossly normal appearance. Cancer patients typically present with an early stage and the prognosis is relatively good.
