Periampullary Lesions Via ERCP in Assuit University Hospital
Condition: ERCP
Study type: Interventional

Summary: 
      A periampullary lesion may be begin as duodenal adenoma, ampullary adenoma, gall stone
      pregnant ampulla, Stricture, or periampullary lipoma, or malignant as pancreatic ductal
      adenocarcinoma, distal CBD cholangiocarcinoma, ampullary carcinoma and periampullary duodenal
      adenocarcinoma, pancreatic carcinoma.

      The aim of the study is to detect incidence of different types of periampullary lesions
      detected by ERCP in Assuit University Hospital and the role of ERCP in early detection,
      diagnosis and management and diagnostic accuracy and sensitivity of biopsy and brush cytology
      taken by ERCP in a period of 1 years starting from June 2017 to June 2018.
    

Detailed description: 
      Periampullary lesion is defined as lesion located in 2CM around the ampulla of Vater.
      Periampullary lesions, identified during endoscopic retrograde cholangiopancreatography
      (ERCP), duodenoscopy or endoscopic ultrasonography (EUS) often present a diagnostic dilemma.
      Although some of these lesions represent a benign lesion, they also occur in case of
      malignancy. Therefore, management of periampullary lesions widely varies from observation for
      low-grade dysplasia to pancreaticoduodenectomy in case of invasive carcinoma. Unfortunately,
      endoscopic biopsies are by definition superficial and, therefore, the risk of a sample errors
      exists. On the other hand the similarity in presentation and the difficulty in accurate
      location of the origin of these lesions often leads to a diagnostic challenge. ERCP in
      addition to its diagnostic value it allows therapeutic procedures, such as sphincterotomy,
      stenting, and nasobiliary drainage. It permits sampling of pancreatic juice, bile, and brush
      or grasp biopsy, but endoscopic biopsies are by definition superficial and, therefore, the
      risk of a sample errors exists .

      ERCP is an invasive procedure that requires an expert endoscopist/radiologist and a
      cooperative patient.

      Very small tumors (< 1 cm) can be missed. A periampullary lesion may be begin as duodenal
      adenoma, ampullary adenoma, gall stone pregnant ampulla, Stricture, or periampullary lipoma,
      or malignant as pancreatic ductal adenocarcinoma, distal CBD cholangiocarcinoma, ampullary
      carcinoma and periampullary duodenal adenocarcinoma, pancreatic carcinoma.

      The aim of the study is to detect incidence of different types of periampullary lesions
      detected by ERCP in Assuit University Hospital and the role of ERCP in early detection,
      diagnosis and management and diagnostic accuracy and sensitivity of biopsy and brush cytology
      taken by ERCP in a period of 1 years starting from June 2017 to June 2018.
    

Intervention name(s): ERCP guided biopsy or brush cytology
Intervention type(s): Procedure
Intervention description(s): ERCP guided biopsy or brush cytology
Intervention model: Single Group Assignment
Intervention model description: All cases admitted in Assuit university hospital with periampullary lesions detected by ERCP with ERCP guided biopsy or brush cytology within the period of the study.
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: periampullary lesions