Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1990 Jun;211(6):649–655. doi: 10.1097/00000658-199006000-00001

Is preoperative angiography useful in patients with periampullary tumors?

W C Dooley 1, J L Cameron 1, H A Pitt 1, K D Lillemoe 1, N C Yue 1, A C Venbrux 1
PMCID: PMC1358103  PMID: 2357127

Abstract

Ninety patients with periampullary tumors, staged by CT scan and believed to be resectable, were staged further by visceral angiography. Most of these patients (78) had carcinoma of the head of the pancreas. Visceral angiography was normal in 62 patients. Major vessel encasement (17 patients) or occlusion (11 patients) was identified in 28 patients. There were no complications related to angiography. Among the 62 patients with normal angiograms, 48 underwent a pancreaticoduodenectomy, for a resectability rate of 77%. Among the 17 patients with vessel encasement, the resectability rate was 35%. For the 11 patients with vessel occlusion, the resectability rate was 0%. Combined with CT scan, visceral angiography is a useful adjunct in the staging of patients with periampullary tumors. Major vessel occlusion precludes resection, and major vessel encasement makes resection unlikely. If visceral angiography is normal, it is very likely that the tumor will be resectable.

Full text

PDF
651

Images in this article

650Fig. 1.
on p.650
651Fig. 2.
on p.651
652Fig. 3.
on p.652

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bookstein J. J., Reuter S. R., Martel W. Angiographic evaluation of pancreatic carcinoma. Radiology. 1969 Oct;93(4):757–764. doi: 10.1148/93.4.757. [DOI] [PubMed] [Google Scholar]
  2. Crist D. W., Sitzmann J. V., Cameron J. L. Improved hospital morbidity, mortality, and survival after the Whipple procedure. Ann Surg. 1987 Sep;206(3):358–365. doi: 10.1097/00000658-198709000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. DiMagno E. P., Malagelada J. R., Taylor W. F., Go V. L. A prospective comparison of current diagnostic tests for pancreatic cancer. N Engl J Med. 1977 Oct 6;297(14):737–742. doi: 10.1056/NEJM197710062971401. [DOI] [PubMed] [Google Scholar]
  4. Dunn E. The impact of technology and improved perioperative management upon survival from carcinoma of the pancreas. Surg Gynecol Obstet. 1987 Mar;164(3):237–244. [PubMed] [Google Scholar]
  5. Grace P. A., Pitt H. A., Tompkins R. K., DenBesten L., Longmire W. P., Jr Decreased morbidity and mortality after pancreatoduodenectomy. Am J Surg. 1986 Jan;151(1):141–149. doi: 10.1016/0002-9610(86)90024-3. [DOI] [PubMed] [Google Scholar]
  6. Jafri S. Z., Aisen A. M., Glazer G. M., Weiss C. A. Comparison of CT and angiography in assessing resectability of pancreatic carcinoma. AJR Am J Roentgenol. 1984 Mar;142(3):525–529. doi: 10.2214/ajr.142.3.525. [DOI] [PubMed] [Google Scholar]
  7. Mackie C. R., Noble H. G., Cooper M. J., Collins P., Block G. E., Moossa A. R. Prospective evaluation of angiography in the diagnosis and management of patients suspected of having pancreatic cancer. Ann Surg. 1979 Jan;189(1):11–17. doi: 10.1097/00000658-197901000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. McConnell F., Thompson A. G., Kiss J. Selective celiac and superior mesenteric arteriography. Can J Surg. 1966 Jan;9(1):15–23. [PubMed] [Google Scholar]
  9. Siegel J. H., Snady H. The significance of endoscopically placed prostheses in the management of biliary obstruction due to carcinoma of the pancreas: results of nonoperative decompression in 277 patients. Am J Gastroenterol. 1986 Aug;81(8):634–641. [PubMed] [Google Scholar]
  10. Stanley R. J., Sagel S. S., Evens R. G. The impact of new imaging methods on pancreatic arteriography. Radiology. 1980 Jul;136(1):251–253. doi: 10.1148/radiology.136.1.7384514. [DOI] [PubMed] [Google Scholar]
  11. Suzuki T., Tani T., Honjo I. Appraisal of arteriography for assessment of operability in periampullary cancer. Ann Surg. 1975 Jul;182(1):66–71. doi: 10.1097/00000658-197507000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Warshaw A. L., Swanson R. S. Pancreatic cancer in 1988. Possibilities and probabilities. Ann Surg. 1988 Nov;208(5):541–553. doi: 10.1097/00000658-198811000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Whipple A. O., Parsons W. B., Mullins C. R. TREATMENT OF CARCINOMA OF THE AMPULLA OF VATER. Ann Surg. 1935 Oct;102(4):763–779. doi: 10.1097/00000658-193510000-00023. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Wong J. H., Krippaehne W. W., Fletcher W. S. Percutaneous transhepatic biliary decompression. Results and complications in 30 patients. Am J Surg. 1984 May;147(5):615–617. doi: 10.1016/0002-9610(84)90125-9. [DOI] [PubMed] [Google Scholar]
  15. Wood R. A., Moossa A. R., Blackstone M. O., Bowie J., Collins P., Lu C. T. Comparative value of four methods of investigating the pancreas. Surgery. 1976 Oct;80(4):518–522. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES