The Pancreatic Head is Larger than often Assumed

Abstract

Reference values for B-mode abdominal ultrasound are controversially discussed in the literature mainly due to the lack of data and non-standardized examination techniques. A cohort of 100 patients was prospectively examined. Patients with hepatobiliary diseases including gallstones, acute or chronic pancreatitis (n = 13) and non-adequate visualization (n = 10) were excluded from statistical analysis. Therefore, 77 patients were analyzed including 52 female and 25 male healthy subjects regarding the biliopancreatic system (median age ± SD: 56 ± 18 years [minimum: 22 and maximum 93 years]). The mean value of the cranio-caudal diameter of the pancreatic head was 49 ± 10 [26 – 77] mm(mean ± SD [minimum − maximum]) which is larger than usually reported except in one study. The size of the pancreatic head is often larger than assumed which is of importance to know to exclude pancreatic pathology below the level of the common bile duct.

Zusammenfassung

Normwerte in der Sonografie werden kontrovers diskutiert. Dies liegt einerseits an fehlenden Studien aber andererseits auch an zu unterschiedlichen Untersuchungstechniken, um einen Vergleich zu ermöglichen. In der vorliegenden Studie wurden 100 konsekutive Patienten prospektiv untersucht. Patienten mit hepatobiliären Erkrankungen wurden ausgeschlossen (Gallensteinleiden, Pankreatitis, n = 13). Des Weiteren wurde Patienten exkludiert, die keine adäquate Beurteilbarkeit des gesamten Pankreaskopfs und seiner umgebenden Strukturen zuließen (n = 10). Somit konnten 77 Patienten ausgewertet werden (mittleres Alter ± Standardabweichung 56 ± 18 Jahre [22 – 93 Jahre], 52 weiblich und 25 männlich). Der mittlere kraniokaudale Diameter des Pankreaskopfs betrug 49 ± 10 [26 – 77] mm. Diese Werte sind deutlich höher als in der Literatur (mit einer Ausnahme) angegeben. Der Pankreaskopf ist in seinen kraniokaudalen Dimensionen häufiger größer als angenommen. Dies ist von Bedeutung, um kaudal gelegene Pankreasneoplasien zu detektieren, die den kranial davon gelegenen Gallengang (noch nicht) infiltrieren.

Key words

reference values - size - adenocarcinoma - pancreatitis - tumors

Schlüsselwörter

Normwerte - Größe - Adenokarzinom - Pankreatitis - Tumor

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