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Clinical Utility of Bile Duct Axis Deviation for Differential Diagnosis Between Pancreatic Head Cancer and Bile Duct Cancer. | LitMetric

AI Article Synopsis

  • The study focuses on differentiating pancreatic head cancer (PHC) from intrapancreatic bile duct cancer (BDC) due to a lack of established clinical standards.
  • Researchers analyzed CT images and measured the bile duct angle (BDA) to assess diagnostic utility alongside other clinical factors in patients who had surgery for either cancer between 2009 and 2016.
  • The findings suggest that a BDA of 130° or less, a main pancreatic duct diameter of 4.3 mm or more, and no jaundice can effectively distinguish PHC from BDC, achieving a strong predictive accuracy.

Article Abstract

Backgrounds: Differential diagnosis between pancreatic head cancer (PHC) and intrapancreatic bile duct cancer (BDC) is important, but no clinical standard has been established. Here we examine the diagnostic utility of bile duct axis deviation and other clinical factors for this differential diagnosis.

Methods: This study enrolled patients who underwent pancreaticoduodenectomy for PHC or BDC at our center between 2009 and 2016. PHCs in groove or uncinate portions were excluded from analysis. From contrast-enhanced computed tomography images, the bile duct angle (BDA) was measured using three points: the junction of intrahepatic bile ducts, upper pancreatic edge, and Vater papilla. Logistic regression was performed to evaluate the diagnostic performance of BDA and other clinical factors for differential diagnosis.

Results: During the study period, 22 PHCs and 31 BDCs were resected. The combination of BDA ≤ 130°, main pancreatic duct diameter ≥ 4.3 mm, and absence of jaundice predicted PHC rather than BDC with an area under the curve of the receiver-operator characteristics curve of .856 (95% confidence interval, .766-.947).

Conclusion: Clinical findings of larger bile duct axis deviation, main pancreatic duct dilation, and the absence of jaundice may be useful for distinguishing PHC from BDC.

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Source
http://dx.doi.org/10.1177/0003134820954851DOI Listing

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