title: Intraportal endovascular ultrasound for portal vein resection in pancreatic carcinoma.
abstract: OBJECTIVE
  Intraportal endovascular ultrasound (IPEUS) has been reported to be the most precise diagnostic procedure for the accurate diagnosis of portal vein/superior mesenteric vein (PV/SMV) invasion in patients with pancreatic cancer. In this study, we evaluated the clinical significance of the length of PV/SMV invasion measured by IPEUS METHODOLOGY: Twenty-six consecutive patients who underwent the pancreatic resection and IPEUS using an autopull-back device between January, 1997 and September, 2000 were retrospectively evaluated. The length of PV/SMV invasion was measured by reviewing the videotapes recorded during the operation. Clinicopathological data and survival were analyzed.
  
  
  RESULTS
  The percentage of PV/SMV invasion was 46%, all of which were treated by PV/SMV resection. The cases without PV/SMV invasion showed significantly longer survival rate. The cases with < or = 18mm PV/SMV invasion, however, achieved a comparable 2-year survival rate of 28% whereas no patient with > 18mm PV/SMV invasion survived more than 18 months after the resection.
  
  
  CONCLUSIONS
  Involvement of the PV/SMV by pancreatic carcinoma seems to be related to the extent of the disease and the PV/SMV involvement > 18mm is associated with a poor prognosis due to high rate of tumor positive margin even with radical operation.
authors.affiliation: Department of Surgery II, Graduate School & Faculty of Medicine University of Nagoya, Nagoya, Japan.
authors.forename: Ekmel
authors.initials: E
authors.lastname: Tezel
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kaneko
authors.forename: Shin
authors.initials: S
authors.lastname: Takeda
authors.forename: Soichiro
authors.initials: S
authors.lastname: Inoue
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Nagasaka
authors.forename: Akimasa
authors.initials: A
authors.lastname: Nakao
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D014743:Videotape Recording