THE USE OF SPIRAL COMPUTED-TOMOGRAPHY IN THE EVALUATION OF VESSEL ENCASEMENT FOR PANCREATIC-CANCER

Conclusions. Spiral CT allows for a noninvasive evaluation of the mese nteric arterial and venous vessels, This test can be performed quicker , with less expense, and with a reduced radiation and contrast load th an angiography, Comparison studies of angiography and spiral CT are ne eded in patients with pancreatic cancer to determine the best method o f evaluating possible vessel involvement, Background. Preoperative ima ging of patients with pancreatic cancer is crucial in determining rese ctability and planning management. Computed tomography (CT) remains th e diagnostic procedure of choice for the evaluation of the primary tum or and angiography is the gold standard to evaluate vessel encasement. This case evaluates the usefulness of spiral computed tomography in d etermining vessel encasement. Methods. A 53-yr-old female presented wi th vague abdominal complaints and evaluation revealed a mass in the pa ncreas. CT suggested portal vein involvement and collateralization was noted in the upper abdomen. Spiral CT revealed normal arterial anatom y and near complete obstruction of the portal vein at the superior mes enteric vein (SMV) splenic vein (SV) confluence. Results. Operative fi ndings 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 co urse was uneventful and she was discharged home on the 13th postoperat ive day.