From 1989 through 1992, endoscopic ultrasonography (EUS) was undertaken preoperatively to evaluate the extent of primary tumor, involvement of regional lymph nodes, and
distant metastases in 22 patients with ampullary carcinoma and 18 patients with bile
duct carcinoma. The results were compared with histopathological findings according to
the TNM staging system. The accurate rate in assessing the extent of cancer invasion was
82% for ampullary carcinoma, 66% for common hepatic duct carcinoma, and 78% for
common bile duct carcinoma. The accuracy of EUS in predicting regional lymph node
metastasis was 59% for ampullary carcinoma, 56% for common hepatic duct carcinoma,
and 67% for common bile duct carcinoma. Invasion of the portal vein was correctly
predicted by EUS in 2 of 3 patients. None of the 3 patients with liver metastasis was
detected by EUS. Therefore, endoscopic ultrasonography is an effective method in the
evaluation of the extent of cancer invasion of ampullary and bile duct carcinoma as well
as the involvement of regional lymph nodes preoperatively. However, due to its limited
penetration depth, EUS is inadequate in the assessment of liver metastasis.
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