BACKGROUND: Diagnostic errors in the evaluation of cystic neoplasms of the pancreas (PCNs) are quite common. Few data are available regarding the impact of these errors on clinical management. The aim of this study was to determine the accuracy of a pancreatic multidisciplinary conference in diagnosing PCNs, to assess the potential risk of misdiagnosis, and to evaluate the clinical impact of these errors. METHODS: A retrospective consecutive series of patients undergoing surgery for PCNs at Karolinska University Hospital between 2004 and 2012 was analyzed. RESULTS: During the study period, a total of 141 patients had undergone pancreatic resection for PCN. The overall accuracy of the preoperative diagnosis was 60.9 %. The rate of concordance between preoperative diagnosis and histology was similar for asymptomatic and symptomatic lesions (62.8 vs. 59.1 %; p = NS). The rate of correct diagnosis increased over time (54.5 % in 2004-2006, 61.7 % in 2007-2012, 63.5 % in 2010-2012). Univariate analysis identified the location of the lesion (diffuse pancreatic involvement) and a mucinous nature of the lesion as factors conducive to a correct diagnosis. Reevaluation of the original indication for surgery in light of the exact diagnosis showed that a surgical procedure should not have been performed in 12 patients (8.5 %). CONCLUSIONS: This study confirms that diagnostic errors are fairly common in the preoperative assessment of PCNs, but the errors are clinically relevant in <10 % of patients.
BACKGROUND: Diagnostic errors in the evaluation of cystic neoplasms of the pancreas (PCNs) are quite common. Few data are available regarding the impact of these errors on clinical management. The aim of this study was to determine the accuracy of a pancreatic multidisciplinary conference in diagnosing PCNs, to assess the potential risk of misdiagnosis, and to evaluate the clinical impact of these errors. METHODS: A retrospective consecutive series of patients undergoing surgery for PCNs at Karolinska University Hospital between 2004 and 2012 was analyzed. RESULTS: During the study period, a total of 141 patients had undergone pancreatic resection for PCN. The overall accuracy of the preoperative diagnosis was 60.9 %. The rate of concordance between preoperative diagnosis and histology was similar for asymptomatic and symptomatic lesions (62.8 vs. 59.1 %; p = NS). The rate of correct diagnosis increased over time (54.5 % in 2004-2006, 61.7 % in 2007-2012, 63.5 % in 2010-2012). Univariate analysis identified the location of the lesion (diffuse pancreatic involvement) and a mucinous nature of the lesion as factors conducive to a correct diagnosis. Reevaluation of the original indication for surgery in light of the exact diagnosis showed that a surgical procedure should not have been performed in 12 patients (8.5 %). CONCLUSIONS: This study confirms that diagnostic errors are fairly common in the preoperative assessment of PCNs, but the errors are clinically relevant in <10 % of patients.
Authors: Maria Moris; David W Dawson; Jennifer Jiang; Jason Lewis; Aziza Nassar; Kenneth K Takeuchi; Anna R Lay; Qihui Zhai; Timothy R Donahue; Kimberly A Kelly; Howard C Crawford; Michael Wallace Journal: Pancreas Date: 2016-10 Impact factor: 3.327
Authors: Johannes-Matthias Löhr; Ragnar Lönnebro; Serena Stigliano; Stephan L Haas; Fredrik Swahn; Lars Enochsson; Rozh Noel; Ralf Segersvärd; Marco Del Chiaro; Caroline S Verbeke; Urban Arnelo Journal: United European Gastroenterol J Date: 2015-12 Impact factor: 4.623
Authors: Kohei Fujikura; Waki Hosoda; Matthäus Felsenstein; Qianqian Song; Johannes G Reiter; Lily Zheng; Violeta Beleva Guthrie; Natalia Rincon; Marco Dal Molin; Jonathan Dudley; Joshua D Cohen; Pei Wang; Catherine G Fischer; Alicia M Braxton; Michaël Noë; Martine Jongepier; Carlos Fernández-Del Castillo; Mari Mino-Kenudson; C Max Schmidt; Michele T Yip-Schneider; Rita T Lawlor; Roberto Salvia; Nicholas J Roberts; Elizabeth D Thompson; Rachel Karchin; Anne Marie Lennon; Yuchen Jiao; Laura D Wood Journal: Gut Date: 2020-10-07 Impact factor: 23.059