Role of angiography in carcinoma of the pancreas as a preoperative assessment.
OBJECTIVE
One of the most important factors effecting the prognosis of pancreatic cancer is successful resection of the carcinoma. Proper staging is essential to such resections. This study attempts to prove the importance of angiographic diagnosis for surgery of the pancreas due to ductal carcinoma. Such diagnosis influences the determination for resection, which in turn impacts patient prognosis.


METHODS
Angiograms of 54 patients who underwent extended pancreatectomy for ductal carcinoma were reviewed. Findings of the angiograms and portograms were classified to four types from the viewpoint of the grade of carcinoma invasion. The angiograms were then compared with pathological determination of carcinoma invasion and the results were compared with patient prognosis.


RESULTS
When arterial invasion was not detectable or limited to intrapancreatic small branches, curative resectability and longer survival rates were expected. In patients with invasion to major arteries adjacent to the pancreas, some patient survival rates were significantly longer than others.


CONCLUSIONS
We overestimated the degree of carcinoma invasion based on arteriography so often that we were not disappointed when aiming for curative resection even when contraindicated by arteriography. Angiography had an important role as a preoperative assessment in carcinoma of the pancreas in terms of curative resectability and survival expectancy.
Mori
M
M
1st Department of Surgery, Okayama University Medical School.
Mimura
H
H
D000792:Angiography; D005500:Follow-Up Studies; D006801:Humans; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate