Evaluating the Frequency of Clinical and Paraclinical Findings in Patients with Pancreatic Tumors: A Retrospective Study

Shamimi, K; Jalali, Seyed Mehdi; Yazdani, Dalir; Etesam, Mehrdad; Zeydani, Maryam

Evaluating the Frequency of Clinical and Paraclinical Findings in Patients with Pancreatic Tumors: A Retrospective Study

Document Type : Original Article

Authors

K Shamimi ¹

Seyed Mehdi Jalali ²

Dalir Yazdani ³

Mehrdad Etesam ⁴

Maryam Zeydani ⁵

¹ Professor of General Surgery, Tehran University of Medical Sciences, Tehran Hospital

² General Surgeon, Tehran University of Medical Sciences

³ Cardiovascular specialist

⁴ General practitioner

⁵ Department of Nursing, School of Nursing and Midwifery, Ahvaz Jondishapur University of Medical Sciences, Ahvaz, Iran

Abstract

Background and Objective: Pancreatic cancer is one of the most deathly malignancies, which causes many deaths in Iran and the world every year. Despite advances and new information about cancers, pancreatic tumors can be diagnosed with different clinical and laboratory symptoms. Therefore, this study was conducted with the aim of investigating the clinical and paraclinical findings of patients with periampullary and pancreatic head tumors.
Materials & Methods: In this cross-sectional study, patients with mass in pancreatic head and periampullary region who underwent surgery at Imam Khomeini Hospital in Tehran between 2011 and 2016 were included in the study according to the inclusion and exclusion criteria. By using the patients' medical records, personal information including age, sex, history of alcohol consumption and presentation symptoms of the patients were recorded. Then laboratory and imaging findings (CT scan and ultrasound) as well as the histopathological types of resected tumor were collected based on the pathology report.
Results: This study included 65 patients; the frequency of men (67.6%) was higher than women (32.4%). The mean age of the patients was 60.6 years. No underlying disease was reported and there was a history of alcohol consumption in 18 patients (27.6%). Jaundice was the most common complaint in all patients and diarrhea was the least common symptom (12 patients). The mortality rate was 4.6%. The mean total bilirubin level was 13.4±3.3, and most of the patients (44 people) had higher than 8. The mean of direct bilirubin was 10.9±2.2, which was more than 8 in most patients (39 people). The mean of alkaline phosphatase, PT, AST and ALT were also increased and were higher than the normal range. Abdominal ultrasound was performed in all patients, which showed dilatation of intra- and extra-hepatic ducts. Other imaging findings included pancreatic head lesions, gallbladder enlargement, and hepatic metastases. CT scan, which was performed in 45 cases, showed similar findings with hypodense foci in the pancreas and hepatic metastases. The most common histopathology observed in the present study was adenocarcinoma (34 patients, 52.3%), while serous adenoma cyst was reported in only one patient (1.5%).
Conclusion: The findings of the present study showed that the prevalence of pancreatic cancer is higher in older and men patients. Also, jaundice and dilation of both intra- and extra-hepatic ducts were the most common clinical and paraclinical findings, respectively. Also, increased bilirubin and alkaline phosphatase are common laboratory symptoms in patients, and adenocarcinoma is the most reported pathology in pancreatic cancer patients.

Keywords

Pancreatic cancer

gallbladder

jaundice

adenocarcinoma

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