Mori M, Mimura H
1st Department of Surgery, Okayama University Medical School.
Hepatogastroenterology. 1995 Sep-Oct;42(5):752-63.
BACKGROUND/AIM: 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.
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.
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.
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.
背景/目的：影响胰腺癌预后的最重要因素之一是癌肿的成功切除。准确分期对于此类切除至关重要。本研究旨在证明血管造影诊断在胰腺导管癌手术中的重要性。这种诊断会影响切除的判定，进而影响患者预后。
回顾了54例行扩大胰切除术治疗导管癌患者的血管造影片。从癌肿侵犯程度的角度将血管造影和门静脉造影结果分为四种类型。然后将血管造影结果与癌肿侵犯的病理判定进行比较，并将结果与患者预后进行比较。
当未检测到动脉侵犯或仅限于胰内小分支时，预期可进行根治性切除且生存率较高。在侵犯胰腺旁主要动脉的患者中，部分患者的生存率明显长于其他患者。
我们常常基于动脉造影高估癌肿侵犯程度，以至于即使动脉造影显示禁忌，在争取根治性切除时也并未失望。就根治性可切除性和预期生存率而言，血管造影在胰腺癌术前评估中具有重要作用。
