Pancreatic cancer is often a late diagnosis, with the signs of extrapancreatic spread already present. Assessment of vascular invasion is an important parameter for determining resectability for pancreatic cancer (fig.1, fig.2). A frequent error is to misdiagnose an involved major vessel [8,14]. Accurate preoperative staging of pancreatic cancer is essential not to deny the opportunity for cure in patients with resectable disease. Our aim was to evaluate the ability of multi-detector computed tomography (MDCT) to assess vascular involvement in patients with pancreatic cancer.

Patients Our study encompasses 20 cases (from September 2009 to August 2011), selected according to the following criteria: tumoral lesions without a perspective of radical surgery due to invasion of a major arterial vessel (the celiac axis, common hepatic artery, hepatic artery, superior mesenteric artery), judged by MDCT, in which the preoperative determination of unresectability was not confirmed during surgery (fig.3, fig4.). This group consisted of 14 men and 6 women with a mean age 59,6±2 years. All patients underwent a preoperative contrast enhanced triphasic...

Among these 20 patients, six (30%) had free of tumor vessels, with the possibility of artery skeletonization, including patients with MDCT signs of invasion (radiological absence of a fat plane between tumor and vessel, wall irregularity, vascular encasement); fig.7-10. Vascular abutment requiring vascular resection during surgery was present in 10 (50%) cases (celiac axis resection was completed in 3 cases); fig. 11-13. 4 (20%) patients had amenable for R0 resection tumor to vessel adjacency, but were found inoperable because of small liver metastasis, missed during...

Pancreatic cancer remains the fourth leading cause of cancer deaths. It has an over-all 5-year survival rate of 4%, while localized cancers have a survival rate of 17% [4]. About 15 to 20% of patients have resectable disease at the time of presentation [6]. Surgical resection offers the only chance for cure with reported 5-year survival rates of 8% to 21% [3]. Tumors are considered unresectable when metastatic disease or local vascular invasion is present. The vessels most often involved are the celiac trunk, the...

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