Portal encasement: Significant CT findings to diagnose local recurrence after pancreaticoduodenectomy for pancreatic cancer

To demonstrate the utility of portal encasement as a criterion for early diagnosis of local recurrence (LR) after pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). A total of 61 patients who underwent PD for PDAC were included in this retrospective study. Portal stenosis was...

Full description

Saved in:

Bibliographic Details
Published in:	Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] Vol. 18; no. 8; pp. 1005 - 1011
Main Authors:	Noie, Tamaki, Harihara, Yasushi, Akahane, Masaaki, Kazaoka, Junichi, Nagao, Astuki, Sato, Shoichi, Watanabe, Kazuteru, Nara, Satoshi, Furushima, Kaoru, Yoshioka, Ryuji, Yamagata, Yukinori, Takeshita, Emiko, Okuyama, Takashi, Sameshima, Shinichi, Oya, Masatoshi
Format:	Journal Article
Language:	English
Published:	Switzerland Elsevier B.V 01-12-2018 Elsevier Limited
Subjects:	Adenocarcinoma Adult Aged Aged, 80 and over Benign Benign portal stenosis Cancer Carcinoma, Pancreatic Ductal - diagnostic imaging Carcinoma, Pancreatic Ductal - surgery Chemotherapy Computed tomography Constriction, Pathologic Diagnosis Disease-Free Survival Dissection Female Fistula Humans Kaplan-Meier Estimate Local recurrence Lymphatic system Male Medical imaging Medical prognosis Metastasis Middle Aged Neoplasm Recurrence, Local Pancreas Pancreatic cancer Pancreatic ductal adenocarcinoma Pancreatic Neoplasms - diagnostic imaging Pancreatic Neoplasms - surgery Pancreaticoduodenectomy Patients Portal encasement Portal System - diagnostic imaging Portal System - pathology Retrospective Studies Stenosis Studies Surveillance Tomography, X-Ray Computed Veins & arteries Portal encasement Benign portal stenosis Pancreaticoduodenectomy Local recurrence Pancreatic ductal adenocarcinoma
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	To demonstrate the utility of portal encasement as a criterion for early diagnosis of local recurrence (LR) after pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). A total of 61 patients who underwent PD for PDAC were included in this retrospective study. Portal stenosis was evaluated by sequential postoperative computed tomography (CT) scans and correlated with disease recurrence. In addition to the conventional LR diagnostic criterion of a growing soft tissue mass, LR was evaluated using portal encasement as an additional diagnostic criterion. Portal encasement was defined as progressive stenosis of the portal system accompanied by a soft tissue mass, notwithstanding the enlargement of the mass. Benign portal stenosis was found on the first postoperative CT imaging in 16 patients. However, stenosis resolved a median of 81 days later in all but one patient whose stenosis was due to portal reconstruction during PD. Portal encasement could be distinguished from benign portal stenosis based on the timing of emergence of the portal stenosis. Portal encasement developed in 13 of the 19 patients with LR, including 6 patients in whom the finding of portal encasement led to the diagnosis of LR a median of 147 days earlier with our diagnostic criterion compared with the conventional diagnostic criteria. Portal encasement should be considered as a promising diagnostic criterion for earlier diagnosis of LR after PD for PDAC.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1424-3903 1424-3911
DOI:	10.1016/j.pan.2018.09.002