Endoscopic ultrasound in differentiation of solid pancreatic head lesions: A single centre experience

Table 1 Diagnosis of pancreatic head mass

Diagnosis	n (%)
Malignant	25 (64.1)
Adeno-carcinoma	24 (61.5)
Neuro-endocrine cancer	1 (2.6)
Inflammatory	11 (28.2)
Auto-immune pancreatitis	2 (5.1)
Tuberculosis	1 (2.6)

Table 2 Demographics, clinical features and biochemical parameters according to nature of head mass, n (%)

Characteristic	Malignant lesion (n = 25)	Benign lesion (n = 14)	P value
Age (years)	60 ± 8.7	63.2 ± 9.3	0.28
Sex (male: Female)	64:36	64:36	0.98
Alcoholics	8 (32)	7 (50)	0.27
Smoking	11 (44)	4 (28.6)	0.49
Significant weight loss	17 (68)	6 (42.9)	0.13
History of acute pancreatitis	0	4 (28.6)	0.012
Chronic pancreatitis	6 (24)	2 (14.3)	0.69
Bilirubin	4.8 (1.4-6.3)	1.8 (0.4-3.2)	0.17
SGOT	54 (34-76)	45 (30-209)	0.77
SGPT	38 (34-78)	38 (32-331)	0.77
ALP	410 (198-506)	396 (110-591)	0.94
CA-19-9	192 (126-417)	156 (16-490)	0.46

SGOT: Serum glutamic-oxaloacetic transaminase; SGPT: Serum glutamic-oxaloacetic transaminase; ALP: Alkaline phophatase; CA-19-9: Carbohydrate antigen-19-9.

Table 3 Endoscopic ultrasound characteristics according to nature of head mass, n (%)

Characteristic	Malignant lesion (n = 25)	Benign lesion (n = 14)	P value
Dilated CBD	19 (76)	9 (64.3)	0.43
Dilated PD	19 (76)	8 (57.1)	0.22
Double duct sign	14 (56)	6 (42.9)	0.43
CBD diameter (mm)	12.8 ± 4.8	10.9 ± 3.5	0.19
PD diameter (mm)	5.2 ± 2.5	3.3 ± 1	0.01
Max diameter of lesion (mm)	32.2 ± 12	31.4 ± 3.2	0.75
Duct penetration	3 (12)	7 (50)	0.03
Surrounding vascular encasement	5 (20)	0	0.14
Significant peripancreatic LAP	9 (36)	1 (7.1)	0.1
Calcification with in the lesion	2 (8)	2 (14.3)	0.6
Echogenicity	Hypoechoic - 16 (64)	Hypoechoic - 5 (35.7)	0.09
	Heteroechoic - 9 (36)	Heteroechoic - 9 (64.3)
Elastography	Heterogenous; predominantly blue - 20 (80)	Heterogenous; predominantly blue- 3 (21.4)	0.01
	Heterogenous; predominantly green - 5 (20)	Heterogenous; predominantly green - 11 (78.6)
Strain ratio	26 ± 7.2 (n = 13)	14.8 ± 10.2 (n = 6)	0.02

CBD: Common bile duct; PD: Pancreatic duct; LAP: Lymphadenopathy.