Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospitals of Geneva, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland.
World J Gastroenterol. 2010 Feb 21;16(7):818-31. doi: 10.3748/wjg.v16.i7.818.
Pancreatic cancer is associated with a poor prognosis, and surgical resection remains the only chance for curative therapy. In the absence of metastatic disease, which would preclude resection, assessment of vascular invasion is an important parameter for determining resectability of pancreatic cancer. A frequent error is to misdiagnose an involved major vessel. Obviously, surgical exploration with pathological examination remains the "gold standard" in terms of evaluation of resectability, especially from the point of view of vascular involvement. However, current imaging modalities have improved and allow detection of vascular invasion with more accuracy. A venous resection in pancreatic cancer is a feasible technique and relatively reliable. Nevertheless, a survival benefit is not achieved by curative resection in patients with pancreatic cancer and vascular invasion. Although the discovery of an arterial invasion during the operation might require an aggressive management, discovery before the operation should be considered as a contraindication. Detection of vascular invasion remains one of the most important challenges in pancreatic surgery. The aim of this article is to provide a complete review of the different imaging modalities in the detection of vascular invasion in pancreatic cancer.
胰腺癌预后不良，手术切除仍然是唯一有治愈机会的治疗方法。在没有转移疾病（这会排除切除）的情况下，评估血管侵犯是确定胰腺癌可切除性的一个重要参数。一个常见的错误是错误诊断受累的主要血管。显然，手术探查并进行病理检查仍然是评估可切除性的“金标准”，特别是从血管受累的角度来看。然而，目前的成像方式已经得到了改善，可以更准确地检测血管侵犯。在胰腺癌中进行静脉切除是一种可行的技术，相对可靠。然而，在有血管侵犯的胰腺癌患者中，通过根治性切除并不能获得生存获益。尽管在手术过程中发现动脉侵犯可能需要积极的治疗，但在手术前发现应被视为禁忌。检测血管侵犯仍然是胰腺外科的最重要挑战之一。本文的目的是全面回顾不同的成像方式在胰腺癌血管侵犯检测中的应用。
