Surgery, Gastroenterology and Oncology
Vol. 24, Nr. 5, Oct 2019
Clinical and Endoscopic Profile of Periampullary Tumour in a Tertiary Care Hospital
Rithesh Reddy G., Vijay Kumar T R., Nandeesh H P., Deepak Suvarna, Aradya H V., Anurag Lavekar, Anil Kumar G.
Article DOI: 10.21614/sgo-24-5-247
Background and aims: Periampullary tumour is a clinical condition often encountered by gastroenterologist and surgeon. There is limited data regarding clinical profile and endoscopic management of patients with periampullary tumour.

Methods: We retrospectively analyzed the ERCP (Endoscopic retrograde cholangio pancreatography) records of periampullary tumour patients who were referred to Department of Gastroenterology for ERCP over a period of three years from January 2015 to January 2018. Demographic profile, clinical findings and ERCP management were taken into consideration. Statistics used were mean and standard deviation for continuous variables, frequencies and percentages were calculated for categorical Variables were determined.

Results: We retrospectively analyzed 86 patients who had undergone ERCP for Periampullary tumours from January 2015 to January 2018. Data interpretation revealed, that majority of the cases were between 41 to 50 years (23.6 %). There was a male preponderance (66.3%). Maximum number of cases were of ampullary growth (46.5 %), followed by lower CBD stricture (32.6 %). The predominant presenting symptom was jaundice (77.9%), followed by abdominal pain (54.6 %). 12 patients (14%) had cholangitis at presentation. Mean bilirubin in the current study ranged from 11.76 to 23.72. CBD cannulation was achieved in 98.8% cases (Selective cannulation 65.1%, precut sphincterotomy 33.7%). Biliary drainage was done using plastic biliary stent (PC) in 84.7% and SEMS (self-expandable metallic stent) in 15.2% cases. Ampullary growth biopsy and biliary brush cytology revealed malignancy in 55% and 35.7% cases respectively. At 3 months, 4 patients with PC stent developed block.

Conclusion: In our study, ampullary growth was the most common type of Periampullary tumour. Cholangitis was present in 14% cases at presentation. ERCP had good success for biliary drainage.Ampullary growth biopsy and biliary brush cytology has sensitivity rate of 50% and 35.7% respectively. Rate of PC stent block was low (< 5%).

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Surgery, Gastroenterology and Oncology is indexed in Scopus, CrossRef (DOI: 10.21614/sgo)

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