OBJECTIVE: To describe the diagnostic work-up and treatment of patients with a pancreatic carcinoma in the Amsterdam area, the Netherlands, particularly in general hospitals. DESIGN: Retrospective, descriptive. METHOD: During 1997, 286 patients with a pancreatic carcinoma were diagnosed in 20 hospitals in the Amsterdam area. Diagnostic work-up and treatment data were collected from the medical records and analysed. RESULTS: Ninety percent of the patients presented in one of the 17 general hospitals (n = 252; 132 men and 154 women; mean age: 70 years). Thirty-five percent of them underwent diagnostic investigations which did not focus directly on pancreatic pathology. Ultrasound was performed in 97% of patients (4% in combination with Doppler) and CT in 60% (4% spiral CT). Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 39% of these patients and endoprostheses were only inserted in half the cases. Thirty-five percent of the patients who underwent both CT and ERCP underwent ERCP first. Ninety-nine patients (39%) were referred to a reference hospital for further investigation or treatment. The period between the first investigation and the histological diagnosis was 4 weeks. CONCLUSION: In the diagnostic work-up of patients with a pancreatic carcinoma, invasive diagnostic procedures were often performed before the non-invasive tests. Spiral CT was used minimally and ERCP was frequently performed without subsequent biliary drainage. The mean duration of diagnostic work-up was relatively long.
OBJECTIVE: To describe the diagnostic work-up and treatment of patients with a pancreatic carcinoma in the Amsterdam area, the Netherlands, particularly in general hospitals. DESIGN: Retrospective, descriptive. METHOD: During 1997, 286 patients with a pancreatic carcinoma were diagnosed in 20 hospitals in the Amsterdam area. Diagnostic work-up and treatment data were collected from the medical records and analysed. RESULTS: Ninety percent of the patients presented in one of the 17 general hospitals (n = 252; 132 men and 154 women; mean age: 70 years). Thirty-five percent of them underwent diagnostic investigations which did not focus directly on pancreatic pathology. Ultrasound was performed in 97% of patients (4% in combination with Doppler) and CT in 60% (4% spiral CT). Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 39% of these patients and endoprostheses were only inserted in half the cases. Thirty-five percent of the patients who underwent both CT and ERCP underwent ERCP first. Ninety-nine patients (39%) were referred to a reference hospital for further investigation or treatment. The period between the first investigation and the histological diagnosis was 4 weeks. CONCLUSION: In the diagnostic work-up of patients with a pancreatic carcinoma, invasive diagnostic procedures were often performed before the non-invasive tests. Spiral CT was used minimally and ERCP was frequently performed without subsequent biliary drainage. The mean duration of diagnostic work-up was relatively long.
Authors: N A van der Gaag; J J Kloek; S M M de Castro; O R C Busch; T M van Gulik; D J Gouma Journal: J Gastrointest Surg Date: 2008-08-23 Impact factor: 3.452
Authors: Steve M M de Castro; Lindsey C F de Nes; C Yung Nio; Daan C Velseboer; Fiebo J W ten Kate; Olivier R C Busch; Thomas M van Gulik; Dirk Jan Gouma Journal: HPB (Oxford) Date: 2010-02 Impact factor: 3.647