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Gastroenterology Surgery Procedure

            Achalasia Cardia
            Hiatus Hernia
            Intestinal Resection
            Appendicectomy
            Hernia Repair
            Gall Bladder
            Splenectomy
            Piles
            Rectal Prolapse
            ERCP (Endoscopic                             Retrograde Cholangio                           Pancreatography)
            Minimally Invasive                               Gastroenterology Surgery
            Cholecystectomy
            Appendectomy
            Surgery For Hiatus Hernia
            Benign And Malignant                         Diseases Of The Food Pipe                 (Esophagus)
            Diseases Of Stomach                          Including Tests For H. Pylori                For Peptic Ulcer
            Diseases Of Small Bowel                      Including Malabsorption                        Syndrome
            Benign And Malignant                         Disorders Of The Biliary Tract
            Acute And Chronic                             Pancreatic Diseases
            Diseases Of Large Bowel
            Liver Diseases Including                       Tests For Viral Profile In                       Hepatitis And Alcohol Related               Problems

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Benign And Malignant Strictures :
Gastroenterology Surgery
Benign And Malignant Strictures India offers information on Benign And Malignant Strictures in India, Benign And Malignant Strictures cost India, Benign And Malignant Strictures hospital in India, Delhi, Mumbai, Chennai, Hyderabad & Bangalore, Benign And Malignant Strictures Surgeon in India.


How to differentiate benign from malignant bile duct strictures?

The main etiology of bile duct strictures closely related to the liver is a malignancy (cancer). However, the differentiation of benign and malignant strictures is notoriously difficult.

The consequences for the patient are considerable because cancer in this anatomical location requires extensive surgery with removal of a large part of the liver. Extensive work-up including multi-slice computed tomography (CT), colour Doppler ultrasonography and magnetic resonance imaging (MRI) may improve the diagnostic dilemma. However, up to date, no single investigation reliably differentiates malignant from benign bile duct strictures.

A research article to be published on August 28, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Prof. van Gulik from the Surgical Department, analyzed a patient cohort that underwent resection for presumed malignancy of the bile duct, during the period 1998 to 2006. The final histologic diagnosis of 68 patients was correlated with the preoperative clinical, laboratory and radiological findings. Fifteen percent patients were found to have a benign lesion. The findings of the different imaging studies revealed that only one feature, i.e. involvement of the blood vessels, showed a significant association with malignany. All other features including clinical presentation, laboratory tests, brush cytology, and other imaging studies were unable to differentiate malignant and benign strictures.

Invasion of the blood vessels was based on the findings of colour Doppler ultrasonography defined as an increase of flow compatible with stenosis, or absence of flow compatible with occlusion. Furthermore, vascular involvement was identified on contrast enhanced CT as vascular stenosis or occlusion of the portal vein and/or the hepatic artery. In 21 patients, the portal vein and/or branches of the hepatic artery were involved in the tumor process, and all these patients were finally diagnosed to have a malignant lesion.



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