Assessment of Pancreatic Duct Dilation in Patients with Pancreatic Cancer and Chronic Pancreatitis using Ultrasonography: A Retrospective Study

ORIGINAL ARTICLE
Zuhal Y. Hamd, Awadia Gareeballah, Ahmed E. Abdelsalam, Sumaiah S. Alshebl, Ghaida A. Aldawas, Rawabi M. Alqahtani, Riyaf A. Almuhatib, Rahaf F. Madani, Basim Abdullah Salih Alhomida

 
International Journal of Biomedicine. 2023;13(1):91-94.
DOI: 10.21103/Article13(1)_OA11
Originally published March 3, 2023

Abstract: 

Background: The present study aimed to assess the main pancreatic duct (PD) in patients with chronic pancreatitis and pancreatic cancer (PC) to determine the prevalence of dilation in both conditions.
Methods and Results: A retrospective study was conducted at King Fahad Medical City in Riyadh from December 2019 to March 2020 on the use of ultrasonography to assess PD in patients with PC and CP. The sample included 73 patients: 39 (21 females and 18 males) with PC and 34 (20 males and 14 females) with CP. The diameter of the main PD was measured by ultrasonography. The mean age for PC patients was 61.17±13.96 years, and for CP patients - 42.14±17.08 years (P=0.000). The diameter of the main PD in PC was 0.52±0.22 cm, and in CP, it was 0.51±0.28 cm (P=0.865). Our results suggest that the dilation of the PD is one feature that accompanies PC and CP. In our study, there was no significant difference in  the prevalence of dilation in both conditions (64.1% and 64.7%).  Additionally, PC is 2.4 times more likely to be associated with diabetes mellitus than CP.
Conclusion: PC occurs more commonly in the older age group, while CP occurs more commonly in the younger age group. Most cases of PC and CP were associated with dilation of the PD with no significant difference in the amount of dilation.

Keywords: 
Pancreatic cancer • chronic pancreatitis • ultrasound • pancreatic duct dilatation
References: 
  1. Korpela T, Udd M, Mustonen H, Ristimäki A, Haglund C, Seppänen H, Kylänpää L. Association between chronic pancreatitis and pancreatic cancer: A 10-year retrospective study of endoscopically treated and surgical patients. Int J Cancer. 2020 Sep 1;147(5):1450-1460. doi: 10.1002/ijc.32971. 
  2. Malka D, Hammel P, Maire F, Rufat P, Madeira I, Pessione F, Lévy P, Ruszniewski P. Risk of pancreatic adenocarcinoma in chronic pancreatitis. Gut. 2002 Dec;51(6):849-52. doi: 10.1136/gut.51.6.849. 
  3. Kirkegård J, Mortensen FV, Cronin-Fenton D. Chronic Pancreatitis and Pancreatic Cancer Risk: A Systematic Review and Meta-analysis. Am J Gastroenterol. 2017 Sep;112(9):1366-1372. doi: 10.1038/ajg.2017.218. 
  4.  Bansal P, Sonnenberg A. Pancreatitis is a risk factor for pancreatic cancer. Gastroenterology. 1995 Jul;109(1):247-51. doi: 10.1016/0016-5085(95)90291-0. PMID: 7797022.
  5. Hassan MM, Bondy ML, Wolff RA, Abbruzzese JL, Vauthey JN, Pisters PW, Evans DB, Khan R, Chou TH, Lenzi R, Jiao L, Li D. Risk factors for pancreatic cancer: case-control study. Am J Gastroenterol. 2007 Dec;102(12):2696-707. doi: 10.1111/j.1572-0241.2007.01510.x. Epub 2007 Aug 31. PMID: 17764494; PMCID: PMC2423805.
  6. Edge MD, Hoteit M, Patel AP, Wang X, Baumgarten DA, Cai Q. Clinical significance of main pancreatic duct dilation on computed tomography: single and double duct dilation. World J Gastroenterol. 2007 Mar 21;13(11):1701-5. doi: 10.3748/wjg.v13.i11.1701
  7. Issa Y, Kempeneers MA, van Santvoort HC, Bollen TL, Bipat S, Boermeester MA. Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis. Eur Radiol. 2017 Sep;27(9):3820-3844. doi: 10.1007/s00330-016-4720-9.
  8.  Adler DG, Anderson MA. The Dilated Pancreatic Duct. ERCP. 2019:354-360. doi: 10.1016/B978-0-323-48109-0.00037-7.
  9. Raimondi S, Lowenfels AB, Morselli-Labate AM, Maisonneuve P, Pezzilli R. Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Pract Res Clin Gastroenterol. 2010 Jun;24(3):349-58. doi: 10.1016/j.bpg.2010.02.007. PMID: 20510834.
  10. Ozenoglu A. Relationship between diabetes, pancreatic cancer, and diet. J Nutr Food Sci Metab. 2022;1(1):1–5.
  11. Setiawan VW, Stram DO, Porcel J, Chari ST, Maskarinec G, Le Marchand L, Wilkens LR, Haiman CA, Pandol SJ, Monroe KR. Pancreatic Cancer Following Incident Diabetes in African Americans and Latinos: The Multiethnic Cohort. J Natl Cancer Inst. 2019 Jan 1;111(1):27-33. doi: 10.1093/jnci/djy090.
  12. Tanaka S, Nakaizumi A, Ioka T, Oshikawa O, Uehara H, Nakao M, Yamamoto K, Ishikawa O, Ohigashi H, Kitamra T. Main pancreatic duct dilatation: a sign of high risk for pancreatic cancer. Jpn J Clin Oncol. 2002 Oct;32(10):407-11. doi: 10.1093/jjco/hyf093.
  13. Luetmer PH, Stephens DH, Ward EM. Chronic pancreatitis: reassessment with current CT. Radiology. 1989 May;171(2):353-7. doi: 10.1148/radiology.171.2.2704799. 

Download Article
Received December 10, 2022.
Accepted January 8, 2023.
©2023 International Medical Research and Development Corporation.