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. 1989 Mar;71(2):92–96.

The value of angiography in the surgical management of pancreatic disease.

G V Appleton 1, N C Bathurst 1, J Virjee 1, M J Cooper 1, R C Williamson 1
PMCID: PMC2498945  PMID: 2705733

Abstract

Selective visceral angiography should help to determine the nature and extent of pancreatic lesions and their suitability for resection. Between 1980 and 1987 coeliac and superior mesenteric angiograms were obtained in 76 patients considered for pancreatic resection. Anomalous arterial anatomy was delineated in 25%. Among arterial abnormalities observed in 42 patients (55%), increased or decreased vascularity and displacement were of limited diagnostic value, but encasement correctly predicted cancer in 18 of 21 cases and irresectability in nine of these. When present (17%), invasion or occlusion of the portal or superior mesenteric vein was even more accurate, indicating cancer in 12 of 13 cases and irresectability in 11 of these. Hepatic metastases were only detected in 7 of 15 patients (47%). Overall, angiography confirmed the diagnosis in 54%, localised the lesion in 64% and correctly forecast irresectability in 58%. Misleading data were obtained in five patients. There were no complications.

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Selected References

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

  1. Braasch J. W., Gray B. N. Technique of radical pancreatoduodenectomy. With consideration of hepatic arterial relationship. Surg Clin North Am. 1976 Jun;56(3):631–647. doi: 10.1016/s0039-6109(16)40938-2. [DOI] [PubMed] [Google Scholar]
  2. Buranasiri S., Baum S. The significance of the venous phase of celiac and superior mesenteric arteriography in evaluating pancreatic carcinoma. Radiology. 1972 Jan;102(1):11–20. doi: 10.1148/102.1.11. [DOI] [PubMed] [Google Scholar]
  3. Clouse M. E., Costello P., Legg M. A., Soeldner S. J., Cady B. Subselective angiography in localizing insulinomas of the pancreas. AJR Am J Roentgenol. 1977 May;128(5):741–746. doi: 10.2214/ajr.128.5.741. [DOI] [PubMed] [Google Scholar]
  4. 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]
  5. Freeny P. C., Ball T. J. Endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC) in the evaluation of suspected pancreatic carcinoma: diagnostic limitations and contemporary roles. Cancer. 1981 Mar 15;47(6 Suppl):1666–1678. doi: 10.1002/1097-0142(19810315)47:6+<1666::aid-cncr2820471435>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  6. Goldstein H. M., Neiman H. L., Bookstein J. J. Angiographic evaluation of pancreatic disease. A further appraisal. Radiology. 1974 Aug;112(2):275–282. doi: 10.1148/112.2.275. [DOI] [PubMed] [Google Scholar]
  7. Hessel S. J., Siegelman S. S., McNeil B. J., Sanders R., Adams D. F., Alderson P. O., Finberg H. J., Abrams H. L. A prospective evaluation of computed tomography and ultrasound of the pancreas. Radiology. 1982 Apr;143(1):129–133. doi: 10.1148/radiology.143.1.7063714. [DOI] [PubMed] [Google Scholar]
  8. LUNDERQUIST A. ANGIOGRAPHY IN CARCINOMA OF THE PANCREAS. Acta Radiol Diagn (Stockh) 1965;235:SUPPL 235–235:1+. [PubMed] [Google Scholar]
  9. Mackie C. R., Cooper M. J., Lewis M. H., Moossa A. R. Non-operative differentiation between pancreatic cancer and chronic pancreatitis. Ann Surg. 1979 Apr;189(4):480–487. [PMC free article] [PubMed] [Google Scholar]
  10. 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]
  11. Mills S. R., Doppman J. L., Dunnick N. R., McCarthy D. M. Evaluation of angiography in Zollinger-Ellison syndrome. Radiology. 1979 May;131(2):317–320. doi: 10.1148/131.2.317. [DOI] [PubMed] [Google Scholar]
  12. Redman H. C., Reuter S. R. Angiographic demonstration of surgically important vascular variations. Surg Gynecol Obstet. 1969 Jul;129(1):33–39. [PubMed] [Google Scholar]
  13. Reuter S. R., Redman H. C., Bookstein J. J. Differential problems in the angiographic diagnosis of carcinoma of the pancreas. Radiology. 1970 Jul;96(1):93–99. doi: 10.1148/96.1.93. [DOI] [PubMed] [Google Scholar]
  14. Rosch J., Keller F. S. Pancreatic arteriography, transhepatic pancreatic venography, and pancreatic venous sampling in diagnosis of pancreatic cancer. Cancer. 1981 Mar 15;47(6 Suppl):1679–1684. doi: 10.1002/1097-0142(19810315)47:6+<1679::aid-cncr2820471436>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  15. SELDINGER S. I. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta radiol. 1953 May;39(5):368–376. doi: 10.3109/00016925309136722. [DOI] [PubMed] [Google Scholar]
  16. Suzuki T., Kawabe K., Imamura M., Honjo I. Survival of patients with cancer of the pancreas in relation to findings on arteriography. Ann Surg. 1972 Jul;176(1):37–41. doi: 10.1097/00000658-197207000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Tylén U., Arnesjö B. Resectability and prognosis of carcinoma of the pancreas evaluated by angiography. Scand J Gastroenterol. 1973;8(8):691–697. [PubMed] [Google Scholar]

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