Epidemiology of bilio-pancreatic cancer in Specialty Hospital UMAE N°71 IMSS in Torreón, Coahuil
Güitrón-Cantú, A.; Adalid-Martínez, R.; Segura-López, F.
Revista de Gastroenterologia de Mexico 76(4): 287-294
2011
ISSN/ISBN: 0375-0906 PMID: 22188952 Document Number: 648781
There is a worldwide increase in the incidence of cancer of the biliopancreatic ducts; early diagnosis is difficult and prognosis is poor. To analyze the frequency of malignant biliary strictures diagnosed by Endoscopio Retrograde Cholangiopancreatography (ERCP) at the "Hospital de Especialidades No. 71 UMAE IMSS", Torreon, Coahuila, Mexico. A 5-year retrospective study of consecutive patients referred for ERCP at our institution was performed. Medical records from patients with malignant neoplasms were reviewed. Demographic variables, post-ERCP and final diagnosis, based on cytological and endoscopic or surgical biopsies, imaging studies and clinical outcome were registered. The frequency of biliary-pancreatic neoplasm was 15.6% (301 cases in 1924 ERCP) determined by bile duct cancer (40.7%), pancreas (27.9%) and Vater´s ampulla (12.3%). Brushing was performed for histopathological analysis in 86.7% of cases. The cytology was positive in 91.2%, negative 8.8%, and it was no possible in 13.3% of cases. Therapeutic endoscopy was performed in 273 patients with complications in 1.3% and no procedure-related mortality. Patients with malignant strictures had a higher risk for unsuccessful ERCP (RR 3.01, 95% CI 1.77 - 5.11) and carrying out pre-cut sphincterotomy (RR 1.80, 95% CI 1.38 - 2.35). In our center the incidence of biliary-pancreatic neoplasm was 15.6% among patients sent to ERCP and its presence increases the degree of difficulty in performing diagnostic and therapeutic endoscopic procedures.