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how to diagnose and differentiate periampullary carcinoma

how to diagnose and differentiate periampullary carcinoma


Differentiation of periampullary carcinoma

Because this disease has upper abdominal discomfort, aundice, sometimes complicated by biliary tract infection, serum amylase is elevated, it can be misdiagnosed as bile duct stones, but based on the history of recurrent episodes, Charcot's triad, fluctuating jaundice, imaging examination can be performed The difference is that a few can be misdiagnosed as infectious hepatitis, which can be differentiated based on the elevated AKP during ampullary carcinoma and the non-parallel development of transaminase and serum bilirubin. There are also misdiagnosed as cholangiocarcinoma and liver cancer, which can be diagnosed based on the imaging of cholangiocarcinoma. Eccentric stenosis, the characteristic sonogram and AFP elevation of liver cancer are distinguished from this disease, and sometimes easily confused with pancreatic head cancer, but the abdominal pain of pancreatic cancer is heavier than this disease. B-ultrasound, CT, etc. can be seen in the pancreas. Lumps can be clinically examined by B-ultrasound, PTC, ERCP, CT, MRI, etc., combined with symptoms and signs, the disease can be diagnosed, and it can be differentiated from related diseases that are easy to be misdiagnosed.

In the past, it was used to include pancreatic head cancer in the periampullary cancer. However, the two have obvious differences in the course of disease, surgical resection rate, prognosis, etc. The latter develops slowly, jaundice appears early, and the surgical resection rate is about 60%, 5 years The cure rate is 40%-45%; while pancreatic head cancer develops rapidly, metastases to the pancreas and surrounding lymph nodes occur rapidly, jaundice appears late, the surgical resection rate is about 20%, and the cure rate is only 10% in 5 years. Differentiation of 4 types of cancer around the ampulla Mainly rely on B-ultrasound, ERCP, PCT and CT or MRI examination, its symptoms and other general identification points.

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