Open AccessAppraisal of Arteriography for Assessment of Operability in Periampullary Cancer
Author(s) -
Takashi Suzuki,
Tomohiko Tani,
Ichio Honjo
Publication year - 1975
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197507000-00013
Subject(s) - medicine , gastroduodenal artery , lesion , artery , superior mesenteric artery , pancreaticoduodenectomy , surgery , angiography , periampullary cancer , radiology , resection
The preoperative arteriograms in 87 periampullary cancers were analyzed in relation to the extension of tumor as explored in surgery, the resectability and the survival time. Most of the patients in whom the pancreaticoduodenal arcades were intact (Group I-O) showed no extension of the lesion into the surroundings and survived more than two years after pancreatoduodenectomy. Those in which the invasion was confined to the anterior pancreaticoduodenal arcade (Group I-A) could also be resected with much anticipation of long survival. About a third of the patients, in whom either the posterior arcade (Group I-P) or both anterior and posterior arcades were invaded (Group I-AP), were resectable. Only a few patients with the involved gastroduodenal artery (Group 2-A) or with the involved superior mesenteric artery (Group 2-P) were treated by extended pancreatoduodenectomy, but they died of recurrence shortly after resection. Further extension of the lesion was explored in surgery when preoperative angiography showed invasion of both the gastroduodenal and superior mesenteric arteries (Group 2-AP) or of the extrapancreatic vessels such as the hepatic artery (Group 3-C), intestinal arteries (Group 3-M) and both (Group 3-CM). Survival in these cases was only a few months after by-pass operation.