Intraportal endovascular ultrasound for portal vein resection in pancreatic carcinoma.
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.
Tezel
Ekmel
E
Department of Surgery II, Graduate School & Faculty of Medicine University of Nagoya, Nagoya, Japan.
Kaneko
Tetsuya
T
Takeda
Shin
S
Inoue
Soichiro
S
Nagasaka
Tetsuro
T
Nakao
Akimasa
A
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