A retrospective study on 40 cases of digestive tumor diagnosed by combination of ultrasound, X-ray and laparoscopy in which the ultrasound and anapathology play a role as screen has shown that the sensitivity and accuracy of ultrasound in the detection of digestive tumors was 97.05% and 87.50%, respectively. However, it should combine the ultrasound with other imaging diagnosis to obtain the higher accuracy
diagnosis ; neoplasms ; Digestive System Diseases

At present, the level of diagnosis and treatment of early gastrointestinal cancer has a larger gap between China and developed countries. In recent years, the advent of new endoscopic imaging techniques has improved the detection rate of early gastrointestinal cancer. Along with this, endoscopic submucosal dissection(ESD) enables radical resection for early cancer. In this article, we discuss how to improve the level of endoscopic diagnosis and treatment of early gastrointestinal cancer.
China ; Endoscopy, Digestive System ; Gastrointestinal Neoplasms ; diagnosis ; surgery ; Humans

The mechanism and principles of autofluorescence imaging based on autofluorescence technique are reported. The threshold value of fluorescence spectrum ratio applied can be quantitative and objective and the reliable measurement method that may provide intuitive method of autofluorescence imaging in the gut mucosa. The suspected lesion may be found rapidly according to the imaging color difference, therefore the results of clinical study of the digestive tract cancer diagnosis indicated that the sensitivity, specificity, and diagnostic accuracy were 94%, 95.5% and 94.8% respectively, and it has very high value in clinical application.
Digestive System Neoplasms ; diagnosis ; Early Detection of Cancer ; instrumentation ; methods ; Endoscopy, Digestive System ; instrumentation ; Fluorescence ; Humans ; Photofluorography ; Sensitivity and Specificity

Humans ; Diagnosis, Differential ; Constriction, Pathologic/diagnosis* ; Bile Duct Neoplasms/diagnosis* ; Endoscopy, Digestive System

The early diagnosis of gastric cancer allows patients and physicians to pursue the option of endoscopic resection, which is significantly less invasive than conventional surgical resection. Newly developed endoscopic technique and devices have helped to overcome the limitations of therapeutic endoscopy in terms of lesion size, location, and presence of fibrotic scarring. As a result, the indications for endoscopic submucosal dissection (ESD) have been expanded from the classical indication for endoscopic mucosal resection (EMR), and there is now support for a further expansion of ESD indications. Long-term follow up data are needed for the clinical application of the expanded criteria of endoscopic treatment. In Korea, the use of endoscopic treatment has been increasing, and many reports on endoscopic treatment such as EMR or ESD have been published. This review was to elucidate the feasibility of the expanded guidelines, based on evidence from long-term outcome.
Cicatrix ; Early Diagnosis ; Endoscopy ; Endoscopy, Digestive System ; Humans ; Korea ; Stomach Neoplasms ; Treatment Outcome

PURPOSE: Cancer of the gallbladder, which is the eighth most common malignancy of the digestive system in Korea, is almost always associated with an unfavorable prognosis, and the clinical outcome has not improved much over the past couple of decades. This study was intended to examine our surgical experience and to evaluate the prognostic significance of the clinicopathological factors for a primary carcinoma of the gallbladder. METHODS: The data of 202 patients with gallbladder carcinomas operated on at our surgical department over a period of 10 years from May 1994 to Dec. 2003 were retrospectively reviewed. RESULTS: Overall, the 5-year survival was 46.8% with the median survival of 58.8 months. The histopathological type and grade, TNM stage, stage grouping, symptom, CA 19-9 level, and jaundice were significant prognostic factors. Among the 85 patients with T2 cancer, the outcome after a resection was better than that after simple cholecystectomy. CONCLUSION: A complete tumor resection and no lymph node involvement are associated with a good prognosis. The long-term survival may be achieved by an early diagnosis with a curative, radical resection. Additionally, a radical resection may be beneficial for patients with a T2 gallbladder carcinoma.
Cholecystectomy ; Digestive System ; Early Diagnosis ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Jaundice ; Korea ; Lymph Nodes ; Prognosis ; Retrospective Studies

No abstract availble
Aged ; Biliary Tract Neoplasms/*diagnosis ; Biopsy ; Endoscopy, Digestive System ; Humans ; Male ; Papilloma/*diagnosis ; Tomography, X-Ray Computed

The prognosis of hilar cholangiocarcinoma is very poor due to its location and complicated anatomical characteristics. The bile duct cancer arising in the hilum easily invades the vascular structures and spreads along the bile duct. Complete curation could only be expected when curative resection of the hilar cholangiocarcinoma had been achieved. For the operability to be decided, the evaluation of longitudinal and vertical tumor extensions are important. Preoperative endoscopic staging work-up could be performed using endoscopic retrograde cholangiography (ERC), choledochoscopy, endoscopic ultrasonography (EUS) and intraductal ultrasonography (IDUS). ERC and choledochoscopic examinations have an advantage that these could take biopsy specimens. However ERC is not superior to either magnetic resonance cholangiography or percutaneous transhepatic cholangiography to make a better evaluation of the extent of the disease. Major problem of ERC is procedure-induced cholangitis, especially in Bismuth-Corlette type III and IV hilar cholangiocarcinoma. Percutaneous transhepatic choledochoscopic examination has an advantage that the stricture site could be examined directly with the availability of biopsy specimens. The diagnostic accuracy rates are different according to the morphological types of cholangiocarcinoma. EUS or IDUS could provide an information about the nodal involvement, the relationship with portal vein and the vertical extension of bile duct cancer. However, further study about the usefulness of EUS or IDUS would be needed in hilar cholangiocarcinoma. Above mentioned endoscopic examinations could be of help to decide the proximal margin of hilar cholangiocarcinoma. Each examination has its own limitations and advantages. Therefore appropriate combination of diagnostic modalities could be helpful to decide the best treatment option.
Bile Duct Neoplasms/*diagnosis ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*diagnosis ; Cholangiopancreatography, Endoscopic Retrograde ; *Endoscopy, Digestive System ; Endosonography ; Humans

Hepatic hemangioma is the most common benign tumor of the liver. Most such hemangiomas are small, asymptomatic, and have an excellent prognosis. Giant hepatic hemangioma has been reported in the literature, but the exophytic and pedunculated forms of hepatic hemangioma are rare. A 56-year-old woman was referred to our hospital under the suspicion of having a gastric submucosal tumor. Abdominal computer tomography (CT) scans showed a pedunculated mass from the left lateral segment of the liver into the gastric fundus, exhibiting the atypical CT findings of hepatic hemangioma. We therefore decided to perform laparoscopic resection based on the symptoms, relatively large diameter, inability to exclude malignancy, and risk of rupture of the exophytic lesion. The pathology indicated it to be a cavernous hemangioma of the liver. Herein we report a case of pedunculated hepatic hemangioma mimicking a submucosal tumor of the stomach due to extrinsic compression of the gastric fundus.
Diagnosis, Differential ; Endoscopy, Digestive System ; Female ; Hemangioma/*diagnosis/pathology/surgery ; Humans ; Liver Neoplasms/*diagnosis/pathology/surgery ; Middle Aged ; Stomach Neoplasms/diagnosis ; Tomography, X-Ray Computed

Subepithelial tumor (SET) is a protruding elevated mass covered with normal appearing mucosa, and is a relatively common finding during esophagogastroduodenoscopy. Recently, the incidence of asymptomatic small SETs is increasing due to esophagogastroduodenoscopy for national gastric cancer screening program in Korea. Unfortunately, the management of SETs is still controversial because the natural history of SETs is hardly known. There are only few studies about the natural history of SETs, especially in the stomach. According to studies, the overall rate of increased size of gastric SETs is 5.4~28%. Tumor size, age, non-upper area of the stomach, and detection of anechoic lesion or echogenic foci on endoscopic ultrasound (EUS) are related with size increase in gastric SETs. Gastrointestinal stromal tumors (GISTs) are one of the most important tumors, and the prognosis of GISTs is closely connected with tumor size, mitotic count, and organ location. Among them, tumor size is relatively easy to approach with esophagogastroduodenoscopy or EUS. Asymptomatic gastric SETs < or =2 cm show a benign clinical course and the malignant potential of them is nearly 0%, even if the gastric SETs are confirmed as GISTs. However, asymptomatic gastric SETs >2 cm, < or =5 cm might be considered for detailed pathologic diagnosis and treatment, if the possibility of GISTs cannot be ruled out. Well-designed, prospective studies are required for more accurate management of SETs.
Diagnosis ; Endoscopy, Digestive System ; Gastrointestinal Stromal Tumors ; Incidence ; Korea ; Mass Screening ; Mucous Membrane ; Natural History ; Prognosis ; Stomach ; Stomach Neoplasms ; Ultrasonography