Sobhrakhshankhah Elham, Zamani Farhad, Ajdarkosh Hossein, Behnam Behdad, Faraji Amirhossein, Khoonsari Mahmoodreza, Nikkhah Mehdi, Ajdarkosh Ali, Safarnezhad Tameshkel Fahimeh, Perumal Dhayaneethie
Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
Commission for Academic Accreditation, Ministry of Education, Khalifa City, Abu Dhabi, UAE.
Middle East J Dig Dis. 2024 Jul;16(3):155-159. doi: 10.34172/mejdd.2024.382. Epub 2024 Jul 31.
Pancreatic duct (PD) dilation could be presented in both benign and malignant diseases. Endoscopic ultrasonography (EUS) is a sensitive modality that provides both structural assessment and tissue sampling. This study aims to explore the importance of PD dilation as a potential indicator related to various pancreatobiliary pathologies identified via EUS.
Among 3109 subjects who underwent EUS, 599 had evidence of dilated PD and met the inclusion criteria of this retrospective study. Also, the patients underwent EUS fine needle aspiration (EUS-FNA) to evaluate the etiology when required. All data were extracted from patients' medical records to perform statistical analysis.
The study sample revealed 64% being male with a median age was 65-years. Pancreatic adenocarcinoma was the most common etiology diagnosed in 236 patients (39.4%), followed by sphincter of Oddi dysfunction (SOD) in 13% of subjects. Ampullary carcinoma, common bile duct stone, and cholangiocarcinoma were found at 9.5%, 8.8%, and 6.8%, respectively. Abdominal pain was the most common symptom seen in 440 (73.4%) patients. Opium consumption was reported in 170 (28.4%) subjects. Opium consumption was significantly more prevalent in patients with SOD (<0.05).
We suggest that PD dilation could be associated with a wide range of pancreaticobiliary pathologies, especially pancreatic neoplasms. In this regard, PD dilation should be considered as a crucial indicator of pancreatic neoplasm despite it may be associated with no clear etiologies.
胰腺导管（PD）扩张可出现在良性和恶性疾病中。内镜超声检查（EUS）是一种敏感的检查方式，可提供结构评估和组织取样。本研究旨在探讨PD扩张作为通过EUS识别的各种胰胆疾病相关潜在指标的重要性。
在接受EUS检查的3109名受试者中，599名有PD扩张证据且符合本回顾性研究的纳入标准。此外，必要时患者接受EUS细针穿刺抽吸（EUS-FNA）以评估病因。所有数据均从患者病历中提取以进行统计分析。
研究样本显示64%为男性，中位年龄为65岁。胰腺腺癌是最常见的病因，在236名患者（39.4%）中诊断出，其次是Oddi括约肌功能障碍（SOD），占受试者的13%。壶腹癌、胆总管结石和胆管癌的发现率分别为9.5%、8.8%和6.8%。腹痛是440名（73.4%）患者中最常见的症状。170名（28.4%）受试者报告有鸦片使用情况。SOD患者中鸦片使用情况明显更普遍（<0.05）。
我们认为PD扩张可能与多种胰胆疾病相关，尤其是胰腺肿瘤。在这方面，尽管PD扩张可能与不明病因相关，但应将其视为胰腺肿瘤的关键指标。
