Percutaneous transhepatic portography with intravascular ultrasonography for evaluation of venous involvement of hepatobiliary and pancreatic tumors

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Abstract

PURPOSE: To determine the safety and utility of percutaneous transhepatic portography (PTP) with intravascular ultrasonography (IVUS) for preoperative evaluation of major spleno-mesenteric-portal venous invasion by tumors of the pancreas, porta hepatis, or liver. MATERIALS AND METHODS: This is a 2-year prospective observational study including 15 consecutive patients (five men, 10 women; mean age, 63.3 ± 10.2) with tumors of the pancreas (n = 8), liver (n = 3), or porta hepatis (n = 4) who underwent PTP/IVUS after computed tomography indicated possible tumor invasion into a major portal radical. Transhepatic portal access was created under fluoroscopic guidance with an 8-F vascular sheath and IVUS was performed with an 8-F, 10-MHz system. When appropriate, operative exploration was performed (nine of 15) and findings were correlated with imaging data from PTP/IVUS. RESULTS: PTP/IVUS was performed successfully in all patients and good visualization of the major portal radicals was achieved. There were no complications from PTP/IVUS, which was performed as an outpatient procedure in most (n = 14) patients. PTP/IVUS provided precise anatomic data regarding the longitudinal and circumferential extent of major portal venous invasion by these tumors. There was excellent correlation between PTP/IVUS and operative findings. CONCLUSIONS: PTP/IVUS can be performed safely in a preoperative outpatient setting and accurately defines the extent of major portal venous invasion by tumors of the pancreas, porta hepatis, and liver.

Original languageEnglish (US)
Pages (from-to)805-814
Number of pages10
JournalJournal of Vascular and Interventional Radiology
Volume13
Issue number8
StatePublished - 2002

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Keywords

  • Liver neoplasms, US
  • Pancreas, neoplasms
  • Portography
  • US, intravascular

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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