Suzuki T, Imamura M, Tamura K, Sumiyoshi A, Sakanashi S, Nishimura Y, Tobe T
Surgery. 1979 Jun;85(6):644-51.
The results of preoperative angiograms and pancreatoductograms in 37 patients with cancer of the pancreas were correlated with each other, with the findings at laparotomy, and with survival times. Tumors which could not be detected by arteriography and/or pancreatography were resectable, except for those located in the uncinate process. Among the resectable tumors, those which were identified only by pancreatography were confined mostly to the parenchyma of the pancreas and were nearly 2 cm in size. Those patients were expected to have a long survival after total pancreatectomy. In contrast, those tumors which were diagnosed only by arteriography arose from the subcapsular portion of the gland or the uncinate process and showed macroscopic invasion to the capsule of the pancreas. These tumors, recurred within 1 year, despite total pancreatectomy. The resectable tumors showing both vascular and ductal invasion were more than 3 cm in size and extended far beyond the capsule of the gland, and patients with these tumors died within 1 year after operation. In this group no difference in survival time was seen among those treated by the Whipple procedure, those by total pancreatectomy, or those by resection of the total pancreas and the portal vein.
对37例胰腺癌患者术前血管造影和胰管造影的结果进行了相互关联分析，并与剖腹手术所见及生存时间进行了关联。除位于钩突部的肿瘤外，血管造影和/或胰管造影未能检测到的肿瘤是可切除的。在可切除的肿瘤中，仅通过胰管造影发现的肿瘤大多局限于胰腺实质，大小近2厘米。预计这些患者在全胰切除术后生存期较长。相比之下，仅通过血管造影诊断出的肿瘤起源于胰腺的包膜下部分或钩突部，并且在肉眼下侵犯了胰腺包膜。尽管进行了全胰切除术，这些肿瘤仍在1年内复发。显示血管和导管均受侵犯的可切除肿瘤大小超过3厘米，且广泛超出胰腺包膜，患有这些肿瘤的患者在术后1年内死亡。在这组患者中，接受惠普尔手术、全胰切除术或全胰及门静脉切除术治疗的患者在生存时间上没有差异。
