간접문맥조영상 담 , 췌 병변의 간외 문맥침윤 양성 - 수술소견과의 비교 = Indirect Portographic Patterns of Extrahepatic Portal Vein Invasion in Pancreaticobiliary Lesions ; Correlation with Surgical Findings간접문맥조영상 담 , 췌 병변의 간외 문맥침윤 양성 - 수술소견과의 비교

다국어 초록 (Multilingual Abstract)

Background/Aims: The aim of this study was to obtain the findings about resectability and curative surgery including portal vein resection in extrahepatic portal vein invasion of invasive pancreaticobiliary lesions. Methods: We analyzed the portographic findings of 64 patients with invasive pancreaticobiliary lesions. All cases underwent indirect portography for evaluation of portal vein invasion and were surgically confirmed(curative resection;40, palliative surgery;24). Pathology of materials were pancreatic neoplasm(n=27, including eleven benign or borderline malignancies), ampulla of Vater cancer(n=15), gallbladder cancer(n=10), bile duct cancer(n 10), duodenal adenocarcinoma(n=l), and leiomyosarcoma(n=l). We classified indirect portographic findings as following 6 types, I: normal, II: simple shift, I1I: unilateral narrowing, IV: bilateral narrowing, V: bilateral narrowing with collateral vein, VI: intraluminal filling defect, and compared pathology, presence of portal vein invasion and possibility of portal vein resection on surgical findings. Results: Portographic type was I;18, II;19, III;11, IV;13, V;2, Vl;1. Benign 1esions were confined to I and II, but malignant lesions were distributed from I to VI. We couldnt find portal vein invasion in all I and II, but could find portal vein invasion in all cases of IV, V, VI, and 55%(6/11) in III. Among 22 cases of portal vein invasion, curative resection including portal resection was possible in 4 cases of type III, 1 case of type IV, 1 case of type VI(6/22;27%). Conclusions: Portal vein invasion can be excluded in type I and II, should be considered in type IV, V, and VI, but in cases of type III, we must consider the site, extension of pathology visible in other images. However, portal vein invasion was not always absolute contraindication of curative resection including portal resection. (Korean 3 Gastroenterol 1995;27:711-718)