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The use of spiral computed tomography in the evaluation of vessel encasement for pancreatic cancer

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Summary

Conclusions

Spiral CT allows for a noninvasive evaluation of the mesenteric arterial and venous vessels. This test can be performed quicker, with less expense, and with a reduced radiation and contrast load than angiography. Comparison studies of angiography and spiral CT are needed in patients with pancreatic cancer to determine the best method of evaluating possible vessel involvement.

Background

Preoperative imaging of patients with pancreatic cancer is crucial in determining resectability and planning management. Computed tomography (CT) remains the diagnostic procedure of choice for the evaluation of the primary tumor and angiography is the gold standard to evaluate vessel encasement. This case evaluates the usefulness of spiral computed tomography in determining vessel encasement.

Methods

A 53-yr-old female presented with vague abdominal complaints and evaluation revealed a mass in the pancreas. CT suggested portal vein involvement and collateralization was noted in the upper abdomen. Spiral CT revealed normal arterial anatomy and near complete obstruction of the portal vein at the superior mesenteric vein (SMV) splenic vein (SV) confluence.

Results

Operative findings confirmed the involvement of the portal vein at the confluence of the SMV and SV. Pancreatico-duodenectomy with portal vein resection and primary anastomosis was performed. The patient's postoperative course was uneventful and she was discharged home on the 13th postoperative day.

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, Mount Sinai Medical Center, One Gustave Levy Place, 10029, New York, NY

    John D. Cunningham & Steven T. Brower

  2. Department of Radiology, Mount Sinai Medical Center, 10029, New York, NY

    Neville Glajchen

Authors
  1. John D. Cunningham
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  2. Neville Glajchen
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  3. Steven T. Brower
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Cunningham, J.D., Glajchen, N. & Brower, S.T. The use of spiral computed tomography in the evaluation of vessel encasement for pancreatic cancer. Int J Pancreatol 19, 9–14 (1996). https://doi.org/10.1007/BF02788370

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  • DOI: https://doi.org/10.1007/BF02788370

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