Idus euroson 2008

447 views

Published on

Published in: Health & Medicine, Education
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
447
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Idus euroson 2008

  1. 1. Advances in diagnosis and staging of bilio-pancreatic tumors: intraductal ultrasonography (IDUS)
  2. 2. Int roduction <ul><li>Diagnosis and staging of bilio-pancreatic tumors is sometimes difficult </li></ul><ul><li>Abdominal ultrasound , computer tomogra phy and magnetic nuclear resonance have increasing sensibility and specificity in diagnosing and staging of bilio-pancreatic tumors </li></ul>Timisoara 2008
  3. 3. Histologic specimen <ul><li>endoscopic ultrasound with fine needle aspiration </li></ul><ul><li>Endoscopic retrograde cholangio-pancreatography (ERCP) </li></ul><ul><ul><li>Brush cytology </li></ul></ul><ul><ul><li>Direct biopsy </li></ul></ul>Timisoara 2008
  4. 4. IDUS <ul><li>Miniprobes </li></ul><ul><ul><li>Diameter : 1- 2,2 mm </li></ul></ul><ul><ul><li>Passed into the working channel of the duodenoscope </li></ul></ul><ul><ul><li>Transpapilary pased into the biliary or pancreatic ducts </li></ul></ul><ul><ul><li>Radiologic control or over the guide wire </li></ul></ul>Timisoara 2008
  5. 5. Timisoara 2008
  6. 6. Timisoara 2008
  7. 7. Exa mination <ul><li>ERCP: cateterization of the stenozis with guide wire </li></ul><ul><li>Probe is passed over the guide through the stenozis, the examination is made retiring the probe </li></ul><ul><li>Duration : 5-15 min </li></ul>Timisoara 2008
  8. 8. Indications : <ul><li>Diferential diagnosis and staging of </li></ul><ul><ul><li>Biliary stenozis </li></ul></ul><ul><ul><li>Ampuloma </li></ul></ul><ul><ul><li>Pancreatic disease </li></ul></ul>Timisoara 2008
  9. 9. IDUS - aims: <ul><li>Feasibility of the method </li></ul><ul><li>Time of examination </li></ul><ul><li>Diagnostic value </li></ul><ul><li>Complications related to the IDUS </li></ul>Timisoara 2008
  10. 10. Results in 17 patients <ul><li>11 biliary stenozis </li></ul><ul><li>2 ampulomas </li></ul><ul><li>4 pancreatic neoplasms </li></ul>Timisoara 2008
  11. 11. Bilary pathology <ul><li>Cholangiocarcinoma </li></ul><ul><li>External invasion </li></ul><ul><li>Intraductal metastatic tumors </li></ul><ul><li>Sclerosing cholangitis </li></ul><ul><li>Mirizzi syndrome </li></ul>Timisoara 2008
  12. 12. ERCP : confluence stenozis Opacification of left intrahepatic ducts after cateterization with guide wire Timisoara 2008
  13. 13. Timisoara 2008
  14. 14. Hilar tumor, peritumoral abcess Timisoara 2008
  15. 15. Main hepatic duct tumor Timisoara 2008
  16. 16. External invasion Timisoara 2008
  17. 17. Intraductal tumors Timisoara 2008
  18. 18. Secondary sclerosing cholangitis Timisoara 2008
  19. 19. Mirizzi syndrome Timisoara 2008
  20. 20. Ampulom a Staging before endoscopic resection Timisoara 2008
  21. 21. Timisoara 2008
  22. 22. Pancreatic neoplasm Timisoara 2008
  23. 23. Conclu sions <ul><li>IDUS is feasible </li></ul><ul><li>Moderate prolongation of the examination </li></ul><ul><li>Useful in selected cases for </li></ul><ul><ul><li>differential diagnosis </li></ul></ul><ul><ul><li>Staging </li></ul></ul><ul><li>No complicationn related to IDUS </li></ul><ul><li>Recomanded for expert endoscopists </li></ul><ul><li>Price? Cost effectiveness? </li></ul>Timisoara 2008

×