Avtor/Urednik		Mlinarič, Vladimir
Naslov		Endoskopska diagnostika malignih tumorjev trebušne slinavke
Prevedeni naslov		Endoscopic diagnosis of the malignant pancreatic tumors
Tip		članek
Vir		Gastroenterolog
Vol. in št.		Letnik 5, št. 1
Leto izdaje		2001
Obseg		str. 19-22
Jezik		slo
Abstrakt		Pancreatic adenocarcinoma represents about 90 % of all pancreatic tumors. In Slovenia, its incidence accounts 10/1000.000. In nearly about 80 % of the patients the local and systemic advanced disease is discovered, so no radical (surgical) treatment is possible thouhg now we have higly accurative imaging diagnostic methods. The reasons are in the absence of effective screening methods, unclear characterized risk groups and late clinical symptoms/signs. Image agnostic algorhythm begins with computerized tomography and abdominal ultrasound. Their accuracy for discovering of tumour lesions in the pancreas, its surrounding and parenchimal organs is between 70% and 95%. Smaller tumours, less than 2 or 1 cm in diameter; with the best prognosis, are difficult to detect by them. By endoscopic procedures, including oesophagogastroduodenoscopy(EGDS), endoscopic ultrasound (EUZ), intraductal ultrasound (IDUS), endoscopic retrograde cholangiopancreatography (ERCP), pancreatoscopy and preoperative laparoscopy (LAP) smaller tumours than 2 cm in diameter can be detected. We can assess their local stagging and probably previously undetected metastases. So the patients can be selected for the most appropriate way of treatment. The most important characteristics, findings of certain investigations and their ranges are described. Also; the algorhythxn of image diagnostic procedures at the patients with suspected pancreatic malignant disease is proposed.
Izvleček		Adenokarcinom pankreasa pomeni okoli 90 % vseh tumorjev trebušne slinavke. Njegova incidenca v Sloveniji znaša 10/100.000. Kljub temu da že imamo na voljo visoko natančne slikovne preiskovalne metode, ugotovimo v približno 80% bolnikov lokalno in sistemsko tako napredovalo bolezen, da radikalno (kirurško) zdravljenje ni več možno. Vzroki so v odsotnosti učinkovitih presejalnih metod, nejasno definiranih ogroženih skupin in poznih kliničnih znakih. Slikovni diagnostični algoritem uvajata računalniška tomografija in abdominalni ultrazvok. Njuna natančnost za ugotavljanje tumorskih sprememb v pankreasu, njegovi okolici in parenhimskih organih je med 70% in 95%. Z njima težje odkrijemo tumorje, manjše od 2 oziroma 1 cm, ki pa imajo najboljšo prognozo. Z endoskopskimi preiskavami, med katere prištevamo ezofagogastroskopijo, endoskopski ultrazvok, intraduktalni ultrazvok, endoskopsko retrogradno holangiopankreatografijo, pankreatoskopijo in predoperativno laparoskopijo, lahko ugotavljamo tumorje, manjšega premera od 2 cm, ocenimo lokalno zamejenost in morebitne, prej neugotovljive zasevke. Tako selekcioniramo paciente za najbolj primeren način zdravljenja. Opisane so najpomembnejše značilnosti, ugotovitve posameznih preiskav in njihov domet. Prikazan je tudi predlagani algoritem diagnostičnih slikovnih preiskav pri bolnikih s sumom na maligno bolezen trebušne slinavke.
Deskriptorji		PANCREATIC NEOPLASMS ENDOSCOPY, DIGESTIVE SYSTEM ADENOCARCINOMA ENDOSONOGRAPHY CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE LAPAROSCOPY